Oral Answers to Questions

INTERNATIONAL DEVELOPMENT

The Secretary of State was asked—

Sierra Leone

Win Griffiths: What plans he has to visit Sierra Leone in the next three months to discuss progress on the agreement made with its Government on the development of Sierra Leone after the civil war.

Hilary Benn: I was in Sierra Leone in March this year. During my visit I had wide-ranging discussions about progress on our 10-year agreement. We are about to carry out a joint review of it with the Government of Sierra Leone.

Win Griffiths: I am sure my right hon. Friend is aware of the strong feeling in Sierra Leone about our Government's great contribution there, both in ending the civil war and in helping to redevelop the country after it. It is good to see the successful reintroduction of democracy with presidential and parliamentary elections and the first local government elections for 30 years. But will my right hon. Friend provide the extra support that will allow the Sierra Leone Government to clamp down on corruption with their anti-corruption measures, so that private industry can go in with confidence and start the economic development that is so necessary to building on that democratic success?

Hilary Benn: My hon. Friend is absolutely right. A great deal of progress has been made in Sierra Leone, partly because of our efforts; but the challenge for the country now is to build on that success, including the recent local elections. Corruption is, I think, the single biggest obstacle to further progress. That is why we are the main supporter of the Anti-Corruption Commission and, with the Commonwealth Secretariat, have provided four judges to focus partly on corruption cases, as well as a special prosecutor for corruption.
	The people of Sierra Leone, however, want to see the Government demonstrate by their actions that they will not tolerate corruption, above all because if they do not tackle the problem it will affect the economic future of a country that has suffered so much.

Angus Robertson: I welcome the progress made in Sierra Leone, but is the Secretary of State concerned about regional instability and the latest worrying reports of violence in Ivory Coast? Apparently more than 5,000 people have had to flee to neighbouring Liberia. What efforts can the United Kingdom Government make to ensure that progress in countries such as Sierra Leone can also be enjoyed in countries such as Ivory Coast that are currently going through such a difficult time?

Hilary Benn: The hon. Gentleman is right. The whole region has been greatly affected; not just Sierra Leone and Côte d'Ivoire but Liberia as well.
	What can we do? First, we must give all possible support to the efforts being made in Côte d'Ivoire to ensure that the peace process that was on track starts up again. I am pleased that President Mbeki is playing a leading role in trying to ensure that the Linas-Marcoussis agreement, which provided the framework for the progress that has been made in Côte d'Ivoire, is upheld and the fighting brought to an end. We do not need any more instability in that part of west Africa. We know from experience that instability can spill into neighbouring states, and they have had quite enough of it already.

Kevin McNamara: My right hon. Friend will know of the close relationship between Hull and Freetown. He will know that ours was the first city to be twinned with the capital of a developing country in Africa. One of Sierra Leone's problems is inadequate training of local government staff. Hull has pioneered a scheme to deal with that problem. What steps will the Government take to arrange more training for local government agency staff in Sierra Leone, to ensure that there is proper administration not just centrally but, more important, locally?

Hilary Benn: I welcome the links of which my hon. Friend has reminded us. The whole focus of our programme in Sierra Leone is indeed on governance reform. That includes public administration, public financial management, decentralisation, reform of the justice system and parliamentary committees.
	Following the achievement of stability through United Kingdom intervention and the work of UNAMSIL—the United Nations Mission in Sierra Leone—the task now is to build the institutions of the state, including local government. The Sierra Leone Government can then begin to do what people look to government to do: meet their needs, educate their children and provide opportunities for economic development.

Remitted Funds

David Heath: What assessment he has made of the role in international development terms of remittance of funds from individuals living and working in the United Kingdom to families in developing countries.

Gareth Thomas: Remittances from the UK are estimated at between £3 billion and £4 billion, with the Indian sub-continent, the Caribbean and sub-Saharan Africa the leading recipients. Remittances are a significant source of income for millions of poor people, making up as much as half the income of those who receive them. In partnership with the private sector and developing-country Governments, we are working to remove barriers to getting remittances to poor people by, for example, promoting competition to bring down costs and better use of technology.

David Heath: I think that the richer countries may be missing a trick. As the Under-Secretary says, remittances from expatriates to their home countries and families can exceed official aid budgets. They also have the advantages of being earned income and money that goes directly to families rather than via governmental routes, which gives remittances greater value. Is there more that the Under-Secretary can do? Can he ask his right hon. Friend the Chancellor of the Exchequer to facilitate remittance transfers, as they are such a significant part of this country's aid effort?

Gareth Thomas: The hon. Gentleman is right that remittances make a huge difference to those who receive them. They mean, on occasion, that children can go to school, and that people can purchase food and access health care. We have established an international taskforce with 15 donors sitting on it, including the Americans, the World Bank and International Monetary Fund, to look at what else we can do to bring down costs and to promote competition worldwide in terms of remittance products.

David Taylor: Migrant workers have become a necessary feature of industrialised countries throughout the world and the Under-Secretary has paid tribute to the importance of their remittances to their home countries. Does not he agree that migration is an important aspect of sustainable development? What is the Government's attitude to the 1990 UN international convention on the protection of the rights of all migrant workers and members of their families, which would help to secure those hugely important remittances to home countries?

Gareth Thomas: My hon. Friend makes an important point about the contribution that migrant workers make in our society. I think, for example, of the Fillipino nurses who work at the key hospital that serves my constituency, and the Sri Lankan Tamils who work in businesses in my constituency. On his specific point about the UN convention, I do not have the answer to hand and will write to him with it.

Medical Training (Africa)

Tim Loughton: What support his Department has provided for the training of (a) doctors and (b) nurses in Africa in each of the last five years.

Hilary Benn: DFID has provided £560 million over the past five years to support health services development in Africa, including the training of nurses and doctors. Of that, an estimated 5 to 20 per cent., depending on the country, is spent on developing the capacity of the work force.

Tim Loughton: I warmly welcome those figures. One of the things that struck me most when I visited Ethiopia two years ago was being told that there are more Ethiopian doctors in Chicago than in the whole of Ethiopia. That pattern is replicated throughout Africa. In places such as Ghana and Zimbabwe, 70 per cent. of doctors leave within five years of graduation. It is right that we should contribute towards the training of health professionals but crazy that we should then poach them; that is still happening in this country through private agencies. Can the Secretary of State apply his mind to thinking more imaginatively about improving terms and conditions, perhaps as part of the aid budget, to ensure that doctors and nurses stay in their home countries, where they are needed most?

Hilary Benn: The hon. Gentleman is right. We have the code of practice in place and my right hon. Friend the Secretary of State for Health is looking at how we can strengthen it. Individuals make decisions to leave countries to seek employment in other parts of the world, but the hon. Gentleman has put his finger on the real issue. How can we do something, working with developing-country Governments, to make it less likely that people will take their skills and expertise away from the country of their birth and travel to other parts of the world? It is about pay, opportunities for continuing professional development, working conditions, the extent to which they will have access to the drugs that they have been trained to use but which may not be available in the communities in which they are placed, accommodation, and whether their children can be educated if they work in rural areas. When I was in Ghana earlier this year, I had exactly that discussion with the head of the Ghanaian health service. His mind was almost exclusively focused on what could be done in Ghana to reduce the factors that push health workers out of that country.

Tony Worthington: The Secretary of State knows that this is an immense problem. As more money goes in to HIV/AIDS and reproductive health, it simply will not be possible to improve health services unless we improve the supply of nurses and doctors. There is no sign of any international effort to tackle that issue. Staff are emigrating; staff are themselves dying from HIV/AIDS and there is a totally unsatisfactory secondary and tertiary health system. Perhaps there should be a World Health Organisation-led effort to deal with the problem of the capacity of health services through human resources in Africa.

Hilary Benn: At its last gathering, the World Health Assembly passed a resolution asking the WHO to look at that very question and will report back next time. It included the proposal for an international code. Quite what that might say and how it would be enforced I cannot say.
	AIDS is having a devastating impact not only on the countries themselves but on the capacity of their health services. That is why we are working with the Government of Malawi, for example, to try to double their health capacity over the next six years. The vacancy rates in Malawi are running at 64 per cent. for nurses, 91 per cent. for obstetricians and gynaecologists and 85 per cent. for surgeons. There are 10 districts in Malawi with no Ministry of Health doctor whatever. That is the scale of the challenge, and we are considering a programme that will include external recruitment, to try to sustain the capacity of the Malawian health service.

Julian Brazier: Everything that the Secretary of State has said on this issue is welcome, but the fact remains that we are still pillaging doctors and nurses from countries that are desperately short of them; a figure even worse than those that he cited is the 97 per cent. shortfall of nurses in Uganda. Will he ask the Secretary of State for Health to take action, not just to tighten the code of practice, but to ban the NHS from taking staff, through private sector agencies, from the countries with the greatest shortfall of medical and nursing staff?

Hilary Benn: The code of practice says very clearly that there will not be active recruitment. The really difficult question, if we are honest, is this; if an individual from a developing country who is a nurse or a doctor chooses to seek employment in the United Kingdom or the United States of America, is it right to have a law that says that they cannot be employed in any capacity in the health service in our country? The individual would say, "What about my right?" Linking back to the earlier question about remittances, one thing that encourages people to seek employment in another country is that they can earn a higher salary so that they can send back money to help sustain their families. One must be aware of the two sides of the argument. The purpose of the code of practice is to prevent active recruitment, and my right hon. Friend the Health Secretary is investigating what more we can do to deal with the problem.

Commission for Africa

Helen Jackson: If he will make a statement on the work of the Commission for Africa.

Hilary Benn: Following the second successful meeting of the Commission for Africa in Addis Ababa, the commission will produce a consultation document shortly, on which it will seek views within and beyond Africa in the run-up to Christmas. I hope that hon. Members will continue to contribute to its work over the coming months. I expect the final report to be published in March 2005.

Helen Jackson: My right hon. Friend will agree that everyone favours giving more support and resources to the development of Africa, but not just on our terms; on African terms. The New Partnership for Africa's Development is an African-owned agenda. How will he ensure that there is some African ownership of the work of the Commission for Africa as it prepares for the G8 summit, not only at Government level, but through all parliamentarians and the men and women of Africa?

Hilary Benn: This is the big challenge for the commission. One of the steps that we have taken is to ensure that the majority of its members are African, so that is a good starting point. I pay tribute to the work that my hon. Friend and others have done through their links with parliamentarians. I know that she is particularly active in AWEPA, the Association of West European Parliamentarians for Africa. The purpose of producing the consultation document is precisely to allow people to see how the commission's thinking is evolving and to contribute to the process. In the end, it is a matter of what recommendations emerge, and I expect that a very strong theme will be what the rest of the world can do to support Africa in helping itself. One practical example is the support that we are giving to the African Union-led initiative in Darfur to increase the size of the ceasefire monitoring team. That is backing an African initiative to tackle conflict in the region.

Quentin Davies: Will this commission actually decide or do anything? If all it does is regurgitate conclusions and policy recommendations already determined by other individuals and bodies, with which we are all familiar, however worthy they are, is there not a most unfortunate danger that the whole exercise could look as if it was more a matter of public relations and the promotion of the Prime Minister on the world stage than a genuine attempt to do something about the problems of poverty in Africa?

Hilary Benn: If I may say so, I am loth to take a lecture of that sort from the hon. Gentleman, and perhaps I might give one practical example of what we are doing. On Africa, the Government are not interested in public relations; in fact, we are in the process of trebling the United Kingdom's development assistance to Africa. Why? The answer is, because we have a rising aid budget. The test of the commission will be the extent to which it supports the process in 2005 in order to get the world to take the steps that need to be taken to help Africa to have a different experience in the next generation from that of the previous one. As the hon. Gentleman well knows, we are taking such steps on volume of aid—as I said, we are in the process of trebling aid, in marked contrast with what went before—on debt relief, for which we have a new initiative, and in respect of the world trading system. What is different is that a serving G8 leader has decided to establish the commission, and has said that Africa will be one of the two priorities for the G8 presidency. That sounds to me like pretty practical politics.

Barbara Follett: Recognising the pivotal role that conflict resolution played in Africa and in the work of the Commission for Africa, will my right hon. Friend say what progress is being made in Sudan?

Hilary Benn: The situation in Sudan, and in Darfur in particular, remains extremely difficult, although I very much welcome the signing of the humanitarian and security protocols at the peace talks in Abuja. This represents a considerable step forward, provided that the parties to those two agreements honour the commitments that they have entered into, and fulfils one pledge that the Government of Sudan gave to the Prime Minister when he visited Khartoum just over a month ago. The humanitarian situation remains difficult, although more aid is getting in. The political process in Abuja will, in the end, provide the solution to the conflict in Darfur.

Alan Duncan: The Commission for Africa offers a unique opportunity for us all to work out from first principles how best to help people escape from, and then stay out of, poverty. Notwithstanding the ravages of AIDS, the problem of corrupt Governments, the misery of displaced people and, indeed, the problem of professionals leaving to work elsewhere—about which we have just heard—does the Secretary of State agree that establishing private ownership and property rights is absolutely essential to building economic progress and, more crucially still, to sustaining such improvements in the long term?

Hilary Benn: Indeed it is important, because economic development will be the real engine of poverty reduction in Africa, as it is in countries such as China and India. At the same time, however, effective states need to be built. That is why increasing aid, our action on debt relief, opening up the world trading system—so that trade is fair for developing countries, as opposed to unfair—and, indeed, private sector development, will have a part to play in enabling Africa to proceed much more successfully than it has until now.

Alan Duncan: I welcome the Secretary of State's words. Some might see them as a slight break with family tradition, and they are all the better for that. But returning to first principles, what study will the commission make of the effectiveness of his own Department's policy in Africa in terms of where it concentrates effort? Would not it be better for the United Kingdom to concentrate its resources on countries with which we have an historical affinity, rather than trying to cover the entire continent, thereby spreading ourselves so thinly that our efforts are rather less effective?

Hilary Benn: We do not try to cover the whole continent; indeed, those African countries in which we have development programmes largely reflect our historical relationship with such countries. But there are other countries with which we have no historical relationship, of which the Democratic Republic of the Congo is a very good example. Now there is an opportunity for peace in the DRC, with an albeit fragile peace agreement and a transitional Government in operation. It would be a mistake if we and other donors did not provide support in such countries, because unless the DRC can consolidate the peace that the political process has delivered, the prospects for development in that part of Africa will not be as good as they would otherwise be.

Iain Luke: I agree with my right hon. Friend entirely. We should be taking steps now to ensure that the mistakes of the past are not visited on the next generation of Africans. Will he take the opportunity at the next meeting of the commission to implore our European partners to scrap the common agricultural policy, a subsidy that protects European farmers at the cost of African producers?

Hilary Benn: We are not going to make progress in the world trade talks without making further progress on reform of the common agricultural policy, particularly on reducing export subsidies. Progress has been made over the last 10 years, during which export subsidies have reduced by more than half in Europe, but they still represent an obstacle to developing countries earning and trading their way out of poverty. I am confident that the commission's recommendations will include some direct comments on the need to conclude the world trade talks in a way that benefits developing countries.

Tom Brake: One of the commission's key recommendations next year is likely to be to boost funds for international development through the international finance facility. The official view on the IFF, as set out in a parliamentary answer, is:
	"Among the G7, France has been a firm supporter of the IFF . . . We are continuing to work with other potential donors",
	but the unofficial view, set out in a background note that was helpfully sent to me at the same time, is:
	"With the exception of France and possibly Canada, the G7 remain sceptical of the IFF . . . Japan, Germany and Italy remain unconvinced."
	Does the Secretary of State agree that it would be risky for developing countries to believe that the IFF was going to provide all their solutions? What are the contingency plans if the IFF does not fly?

Hilary Benn: The first thing that we can do is to demonstrate that the IFF model works. That is why we are currently working with the Global Alliance for Vaccines and Immunisation on an immunisation pilot IFF, which will allow many more children to get immunised than is currently the case. It will also show other countries that remain to be convinced that the model works and that it is the one practical proposal on the table that will raise additional development finance now, which is what we need if we are to make progress towards the millennium development goals. The question that the sceptics have to answer is, if not the IFF, what other proposals are there for raising the additional finance now? The finance is needed now to invest in the long-term development of Africa and other developing countries. [Interruption.]

Mr. Speaker: Order. The House must come to order.

Uganda

Valerie Davey: What assessment his Department has made of the humanitarian situation in northern Uganda; and if he will make a statement.

Hilary Benn: The humanitarian situation in northern Uganda is an emergency, but overall rates of mortality and malnutrition suggest that it is currently under control across the north as a whole. However, we have just received a report from Médecins sans Frontières (Holland) of alarmingly high mortality rates amongst displaced people in one part of the north. We are urgently investigating. Since December 2002, the UK, which is the second largest donor, has provided £15 million of humanitarian assistance, channelled mainly through the World Food Programme, UNICEF and the Uganda Red Cross.

Valerie Davey: I thank my right hon. Friend for his reply and for his interest in this largely unreported disaster. Can he be confident that the aid is reaching the north, as the latest BBC news talks of the staggering death rate in northern Uganda, especially among the under-fives? Is he sure that the Ugandan Government's funding is prioritising northern Uganda?

Hilary Benn: Based on my visit to Gulu earlier this year, I can tell my hon. Friend that I have seen the benefits of the aid that we are giving, not least the support given to the children who are so blighted by the conflict. Work is also being done to reintegrate into society the children who have been abducted, traumatised and brutalised by the Lord's Resistance Army. The excellent Gulu Support the Children Organisation is in operation, with support from ourselves and others to help those children.
	Clearly the potential for development in northern Uganda is being blighted by the conflict and I very much welcome reports that the Lord's Resistance Army now wishes to bring the conflict to an end and to open dialogue with the Government. We support efforts to make that happen but, based on past experience, the question remains whether it really means it. We must work with might and main to ensure that, if that opportunity now exists, it comes to fruition.

World Trade

Jonathan Sayeed: What action he has taken to ensure the success of the interim accord in furthering negotiations in the Doha round; and if he will make a statement.

Gareth Thomas: My right hon. Friend the Secretary of State and I will continue to talk to the European Commission, other EU member states and developing country Ministers to encourage progress towards a successful development outcome on the Doha development agenda. We continue to provide substantial ongoing assistance to developing countries to support them in these negotiations.

Jonathan Sayeed: I am sure that the Under-Secretary means what he says, but we have had the talks at the general agreement on tariffs and trade, Uruguay and Cancun, and now we have Doha. Yet all the time agricultural protectionism and dumping are making the poorer nations poorer. When will the EU and the US understand that the richer the world is, the more people can afford the goods and services that we produce? Is not it common sense, and in our common interest, to end policies that make the poorest poorer?

Gareth Thomas: The hon. Gentleman is absolutely right to point out the need for us to make progress and to get a good outcome from the Hong Kong ministerial meeting in December next year. Although there has been rapid growth in world trade over the past 10 years, Africa's share has halved in that time. My right hon. Friend the Secretary of State for Environment, Food and Rural Affairs successfully negotiated a deal on reform of the common agricultural policy in 2003, and that was a significant step in the right direction. We continue to press the Commission and our friends in the US to go further.

PRIME MINISTER

The Prime Minister was asked—

Arctic Star Campaign Medal

Julian Lewis: If he will make it his policy to recognise the service of personnel on the Russian convoys by the award of an Arctic Star campaign medal.

Tony Blair: Perhaps I can answer this question in a little detail, if I might. First, we owe the heroes of the Arctic convoys an immense debt of gratitude. They risked, and in many cases gave, their lives under some of the harshest conditions imaginable in order to keep this nation free and democratic in the second world war.
	The Government at the time honoured those who took part in wartime convoys to the Soviet Union with the award of the Atlantic Star, and that explicitly included service on the convoys to north Russia. The difficulty that arises is that the eligibility criteria for the range of medals instituted to recognise second world war service was drawn up by the Committee on the Grant of Honours, Decorations and Medals. The King approved the proposals in the late 1940s, and subsequently ruled that no further medals should be instituted for second world war service. However, questions have been raised about the relative difficulty of qualifying for the Atlantic Star through service on the convoys. We continue to look at this matter, but it is extremely difficult, at the moment, to see a way through.

Julian Lewis: I thank the Prime Minister for that thoughtful reply, but that is not the answer that these courageous men were hoping to hear the day before Remembrance day. He is right about the problem with the Atlantic Star, and that story really will not do. A man had to serve for six months to qualify for the Atlantic Star, but most of those on the Russian convoys who received that medal did so despite the fact that they were on the convoys. Hundreds of men who were on those convoys did not get the Atlantic Star, because they were not on them for six months. Finally, may I remind the Prime Minister that hundreds of hon. Members—including the Home Secretary, the leader of my party and many members of all the other parties in this House—have said that they want this medal to be awarded? He has it in his power to overrule the bureaucrats: will he now do so?

Tony Blair: First, I assure the hon. Gentleman that I am as anxious as anyone else to resolve the issue, and of course I should like to resolve it in the way that he and many other hon. Members have suggested. However, he will know that the six-month qualifying service required at the time has been reviewed independently on many occasions, and the recommendation has always been to retain it. I repeat that we are trying to find a way through this difficulty. [Interruption.] It is not simply for me to decide. We have to act in a way that satisfies the armed forces. That continues to be the subject of discussion.

Calum MacDonald: My right hon. Friend will be aware that next year is the 60th anniversary of the end of the second world war. Does he agree with me that, with each decade that passes, it becomes ever more important to remember and commemorate the sacrifice of that great generation of the 1940s? They fought in the Arctic, Europe and Asia to defend our liberties and democracy, and to create democracies in countries that previously did not know democracy.

Tony Blair: I entirely share—as I am sure does the whole House—in my hon. Friend's tribute to the bravery and dedication of all those who served our country during two world wars. The Minister of State with responsibility for the armed forces will today announce plans to commemorate the 60th anniversary of the ending of the second world war. With British troops serving in Iraq and in many other places, Remembrance day will take on a special significance for this country at this time.

Engagements

Sarah Teather: If he will list his official engagements for Wednesday 10th November.

Tony Blair: Before listing my engagements, I know that the whole House will join with me in sending our deep condolences to the family of the Black Watch soldier killed by a terrorist bomb in Iraq on Monday and our sympathy to those soldiers injured in the same attack. Once again, we praise the courage and heroism of our armed forces and, once again, we say that this country can be very proud of them.
	This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall have further such meetings later today.

Sarah Teather: I associate myself with the comments made by the Prime Minister.
	The College of North West London has a reputation for excellence in construction, is one of the largest providers of skills for life courses in the country and has been called the Cambridge of plumbing. The Government want the further education sector to provide courses in those priority areas on a demand-led basis, but have not provided the money to meet demand in my area. What advice can the Prime Minister give to the principal of my local college? Should she turn away the students that he has asked her to recruit, or risk the financial viability of the institution?

Tony Blair: I cannot comment in detail on the funding of the college in the hon. Lady's constituency. However, I can say that we have massively increased the investment in further education. There are now 250,000 modern apprenticeships, and that will rise to 300,000 during or by the end of 2006. There are always difficulties with exactly how funds are allocated, but in addition to all the money that we are putting in, we are making a new offer to people of free level 2 skills funding for all who need it. I am aware that that will not cover everyone in her college, but we are increasing investment massively and I will have to get back to her on the precise details of her college.

Mohammad Sarwar: My right hon. Friend is aware of the depth of feeling across Scotland about the future of Scottish regiments. Can he assure me that the Government will listen to public opinion and respond positively to the desire to retain their historic identities and traditions?

Tony Blair: I fully understand the concern expressed about the uncertainty affecting the future of the regiments in Scotland. The Chief of the General Staff, General Sir Mike Jackson, is considering at present how best to implement changes designed to modernise the way in which infantry regiments are deployed, and he will continue to do that. No final decision on the future structure of Scottish regiments has yet been made and I ask people to wait a little longer until the final decision is made.

Michael Howard: I join the Prime Minister in expressing my sympathy and respect to the family of the latest member of the Black Watch to lose his life on active service in Iraq, and I wish those who have been injured a full and speedy recovery.
	The whole House will have been disappointed to hear the Prime Minister's answer to the hon. Member for Glasgow, Govan (Mr. Sarwar). The Black Watch is doing a heroic job in Iraq. Why cannot the Prime Minister confirm now that he will reverse his policy on the regiment's future? Why cannot he tell the House now that the courage and dedication of the Black Watch will not be rewarded by the abolition of the regiment?

Tony Blair: It is not a question of reversing the policy. The decision has to be made by the Army, because it wants to configure itself in the best and most effective way possible. No decision has yet been made. We are well aware of the concerns that have been expressed and we have expressed our own admiration—it is not a matter of difference on either side of the House—of the Black Watch's heroism and the work that it is doing. However, it is important that the Army be allowed to make its decision in the right way. It will do so and announce it shortly.

Michael Howard: But cannot the Prime Minister see that the way in which this whole issue has been handled is a complete shambles? The Secretary of State for Defence has said repeatedly that the Scottish regiments will be abolished, but the Prime Minister has briefed newspapers in Scotland that they will be saved. I have the headline here: "Saved!"—[Interruption.]

Mr. Speaker: Order. Let the Leader of the Opposition speak.

Michael Howard: The headline reads: "Saved. Blair orders about turn on the Black Watch and 3 other Scots regiments". Does the Prime Minister not understand how shameful it is to treat the Black Watch and their families in that way at a time when they face such great danger in Iraq?

Tony Blair: I am surprised at the right hon. and learned Gentleman's behaving in this way. He knows perfectly well that the Army has to make that decision and is considering it now. The Army will make that decision in due course. No one has announced that the regiments are to be abolished; a decision has to be taken by the Army on the most effective way to do it. We are well aware of the concern, but it has to be done in the right and proper way, and I simply regard what the right hon. and learned Gentleman is saying today, in particular his attempt to say that somehow we are undermining the Black Watch in Iraq, as completely wrong and just another example of his shabby opportunism.

Kevin Hughes: While I appreciate that the big drug companies spend an awful lot of money on research and development, it is also a well-known fact that they make hundreds of millions of pounds from the national health service, so is it not about time the Government got a better deal for the NHS and the British taxpayer?

Tony Blair: It is precisely for that reason that I am delighted to be able to tell my hon. Friend that, as a result of the deal secured by the Secretary of State for Health, there will be savings in the region of £300 million or more on the drugs bill. That is extremely important and it shows how we are getting good value for money in a health service that is improving and expanding capacity, treating more people and treating them better. We are well on the way to the renewal of the national health service in this country.

Charles Kennedy: I associate myself entirely with the Prime Minister's initial comments about the further loss of life of a member of the Black Watch and the injuries sustained by others in their support. May I ask the Prime Minister about the current duties of the Black Watch in Iraq? It is reported that the Prime Minister has been assuring his colleagues that further British troops will not be required to replace the Black Watch when its 30-day redeployment is complete. Is it the case that he has been briefing his colleagues to that effect and can he tell Parliament whether British troops, generally, will continue to operate outside their southern sector after Christmas?

Tony Blair: I have not been giving any particular briefings to colleagues about that, so all I can do is repeat what I said to the right hon. Gentleman on Monday, or perhaps last week: there are no plans to redeploy further British troops once the Black Watch has ceased those operations in the particular area the regiment is in at present. That was the case then and it remains the case now. It is obviously important that the Black Watch is there for the moment, as it is an integral part of the operation in Falluja.

Charles Kennedy: In addition, given that we know that leading Iraqi insurgents have, in many cases, already left Falluja and that violence is flaring across the country, would the Prime Minister be prepared again to authorise the redeployment of British troops elsewhere in Iraq in support of other American-led military operations?

Tony Blair: I do not think that it would be sensible for me to speculate about what might happen in the future in relation to British troops. Perhaps we should say this. First, we should pay tribute not just to the British forces but to American and Iraqi forces for what they are doing in Falluja. Let me make three things very clear. First, many of those in Falluja are foreign jihadis from outside Iraq; they are people who have no right to be in Iraq at all. Secondly, the operations—[Interruption.] I am sorry, but al-Zarqawi was in Iraq before the end of Saddam Hussein's regime. So, first, many of the people in Falluja are foreign, outside terrorists. Secondly, let me say again that we would cease operations now in Falluja—immediately—if they would lay down their weapons and agree to participate in elections; and, thirdly, the real desire of those terrorists is to stop the elections, because they know that if there are elections in Iraq, as there have been in Afghanistan, that will be a huge blow to them, as terrorists.
	I have to say to the right hon. Gentleman that I cannot start making predictions or talking about what future operations there may be, but he knows that this was a special operation for particular reasons of immense importance to making the elections secure in Iraq. There are no plans to redeploy British troops in replacement of those.

Helen Southworth: My constituents want police officers who know the local area and are known by local people. Will my right hon. Friend back extra resources for community policing in Warrington?

Tony Blair: We want to increase support for community policing, not just in my hon. Friend's constituency, but elsewhere in the country. We have now got record numbers of police. We are supplementing them now with community support officers and neighbourhood wardens, and what we are trying to do is bring back proper community policing for today's world. As I saw myself when I visited some of the community support officers yesterday, they are doing a magnificent job, and for the future they, along with fully warranted officers, will be a major part of a modern police service.

Michael Howard: Last week, the Prime Minister and the leader of the Liberal Democrats urged voters in the north-east to vote yes in the referendum on the regional assembly. The next day, 78 per cent. of them voted no. Why does the Prime Minister think that more than seven out of 10 people in Sedgefield rejected his advice?

Tony Blair: It had not escaped my attention that they voted no, because they obviously decided that a regional assembly in the north-east was not the way that they wanted to go. Fair enough. We said that we would give them the vote. They voted. We abide by the result, and we will now continue to strengthen local democracy in other ways.

Michael Howard: Is it not clear that the lesson of last week is that people want local government and less government, not more government? There are now eight regional assemblies in England. They cost millions of pounds. We now know that they have no popular support at all. When will the Prime Minister abolish them?

Tony Blair: We will not abolish them, because they perform a perfectly good task of co-ordinating action in the regions. Of course, what they build on are the Government offices for the regions, established by the previous Government, which actually cost five to six times the amount of the regional assemblies.

Michael Howard: We did create the Government offices for the regions. We moved civil servants from Whitehall to the regions. The Prime Minister should do rather more than that, but I am not asking him about the regional offices; I am asking him about the regional assemblies. Has he not learned any lesson at all from last week's vote? People do not want important matters, such as planning and housing, taken away from local councils, which people identify with, and given instead to regional assemblies, which they do not identify with. The people have spoken: regional assemblies are dead. Why does not the Prime Minister bury them?

Tony Blair: The vote was not on the regional chambers, and if the right hon. and learned Gentleman is so against them, can he please explain to me why so many Conservatives serve on them?

Michael Howard: Because as long as they are there, Conservative councillors have to minimise the damage that they do, but Conservative councillors, like me, want them abolished. Why will the Prime Minister not abolish them?

Tony Blair: If the Conservatives want them abolished and they think that they serve no purpose, I am surprised that they sit on them. The fact of the matter is that they most certainly do serve a purpose, but the reason why the previous Government established the Government offices for the regions is that they recognised that there had to be a regional dimension. That is precisely what we have recognised with the regional chambers. There will not be a regional assembly in the north-east, because they did not vote for one. What will remain are the Government offices for the regions and the regional chambers.

Ann Clwyd: May I ask my right hon. Friend to look urgently at reports that some civilians caught up in the fighting in Falluja cannot access urgent medical treatment? May I ask him again to say that surely the main objective now must be to ensure that as much of Iraq as possible is made safe so that free and fair elections can take place next year and the people of Iraq can choose their own elected representatives?

Tony Blair: The points that my hon. Friend makes are absolutely right. We are doing our best to get supplies, especially medical supplies, through to people in Falluja, but the current problem is that some of the terrorists and insurgents are trying to kill those who are bringing the supplies through. As Prime Minister Allawi made it clear, the Iraqi Government are going to redouble their efforts to achieve that. My hon. Friend's point is absolutely correct, because if the terrorism stopped, many things could happen in Iraq. The reconstruction could proceed more easily and investment in Iraq could be there. The elections—locally and nationally—could take place properly. That is why it is important that whatever the difficulties and people's views on the conflict in Iraq, we stand firm and see this through, because that is in the interests not only of the Iraqi people, but of the wider world.

Lewes

Norman Baker: When he last visited the Lewes constituency.

Tony Blair: Regrettably, I have been unable to do so. It says here in brackets that, if necessary, I hope to visit the hon. Gentleman's constituency at some point in the future.

Norman Baker: I very much hope that the Prime Minister will do so because my constituents have many things to say to him—some even complimentary.
	Will the Prime Minister raise the issue of climate change when he reports for duty in Washington tomorrow? Given the importance that he attaches to the issue and the fact that President Bush has been the main obstacle to international progress on climate change, are we to conclude that he has not been raising the matter with President Bush, or have his concerns been contemptuously swept away in this one-way street of a special relationship?

Tony Blair: The difference between us and the American Administration on climate change is well known, although it is not only a difference with this particular Administration—I think I am right in saying that the Senate vote against the Kyoto protocol was something like 100 to nothing. The difference is clear and well documented. However, I must tell the hon. Gentleman and other Liberal Democrat Members who cavil at our relationship with the United States that none of the issues—not climate change, not the Palestinian peace process, not the changes we want to see in the world—will be addressed without the engagement of the United States of America. We should be proud of our relationship with it.

Liam Byrne: The Prime Minister will be aware that the Palestinian nation today faces hours of maximum uncertainty. What will he do in Washington to help to focus the American President on delivering a prosperous, stable, two-state solution in the middle east?

Tony Blair: As I set out last week, I will obviously stress again the importance of the middle east peace process. As I think that I said in the statement straight after President Bush's re-election, that, together with democracy in Afghanistan and Iraq, is the single most important thing that we can do.

Engagements

Simon Hughes: The Prime Minister often, and rightly, stresses the importance of giving choice to people in their use of public services. Why then does he not accept Labour party policy and the views of thousands of people among the 2.5 million council tenants in England, including nearly 50,000 in my borough, who want to remain as council tenants yet still have the same right to investment in decent homes as people whose homes are transferred to other management, private finance, or alternative management systems?

Tony Blair: Surely the whole point is giving people the ability to transfer if they want to. When they transfer, as many have done, many find that there is an improvement, but in the end the decision to do so is their choice.

John MacDougall: I join my right hon. Friend in his comments regarding all the troops out in Iraq and thank him for them. May I pay a personal tribute to a local lad who was a brave young Scot serving in the Black Watch? He paid the ultimate price; he lost his life for being a brave young solider. I hope that the Prime Minister will join me in paying respects to Private McArdle's family today. Does he believe that there is a wider agenda? Although all the concentration is understandably on Iraq at the moment, the road map is vital to stabilise the middle east.

Tony Blair: I agree with my hon. Friend, but first I want to express my condolences publicly to the family of Private McArdle and to the families of others who have lost their lives in recent days and during the time of our action in Iraq.
	My hon. Friend is right. The road map and the middle east peace process are an important part of the battle in which we are engaged. It is increasingly obvious that we face a global movement of a new type of terrorism. Many of those people fighting in Afghanistan and Iraq are part of the same network that has caused atrocities all over the world. The important way to fight it is, of course, by security means, as we have done in Afghanistan and Iraq, but also by removing the cause of so much discontent and the sense of injustice by ensuring that we make progress on the middle east peace process and on resolving the Palestinian issue. If we can combine the measures on security with those measures that let us understand some of the sense of injustice that there is in the world, we have a better chance of defeating this terrorism and defeating it finally.

Simon Burns: Will the Prime Minister reflect on the genuine anger in Chelmsford at the 14,000 extra houses that are being imposed on us? Will he tell me and my constituents why democratically elected borough councillors cannot take that decision, given that they know the area and its needs better than central Government?

Tony Blair: Surely the issue is that we have to expand housing provision in the south. We know that. We are trying, as other Governments before us have done, to find a way to do that that preserves the green belt, by building primarily on brownfield sites, to provide the homes that people in the south need to live in. If we do not provide those homes, we face rising house prices and many people find it difficult to get a home in the south. Of course people do not like particular developments in their own area, but if we are not able to do this on a proper and planned basis, we will not be able to provide the homes that people need in the hon. Gentleman's constituency and elsewhere.

Chris McCafferty: My right hon. Friend will be aware that the Duke of Wellington's Regiment was recently deployed to Iraq for a second tour of duty in 14 months. Is he also aware that the regiment faces the indiscriminate chop by the Army review board while fighting in a conflict? Will he take a personal interest in the future of the Dukes, which is one of the Army's oldest and best recruited regiments?

Tony Blair: I certainly will. My hon. Friend's question underlines the importance of ensuring that decisions are taken together and can be justified in all parts of the country. We are well aware of the huge attachment that people have to particular regiments. We have to ensure that that is married with the necessary efficiency of the Army in today's world. That is what the Army chiefs of staff want to do.

Tom Brake: The Prime Minister will have heard reports earlier today that refugees in camps in Darfur have been attacked by the Sudanese police. I am meeting the Sudanese ambassador in half an hour. Is there a message that I can convey to the ambassador from the Prime Minister?

Tony Blair: Sudan does have to honour its commitments. If it does not, it needs to be well aware that there will be a serious response from the international community. Time is running out, frankly, for it to honour those commitments. The commitments were given to me, the United Nations and others. They are vital. If they are not honoured, Sudan has to understand that there will be a serious response from the international community. I very much hope that in the weeks to come it will recognise that both the advent of the African Union peacekeepers and the fact that the issue will be very much in the minds of the international community—even with everything else going on—mean that it has to come into line with the obligations it has entered into.

Brian H Donohoe: My right hon. Friend will know about the Lyons review as part of his role as Minister for the Civil Service. Does he understand that it excludes my constituency and, indeed, the whole of Ayrshire? Will he correct that anomaly?

Tony Blair: I have just been informed that that is not correct, so I am not sure that I have to correct the anomaly, but I will certainly look into the matter for my hon. Friend. The important point to make to him is that the relocation programme, presented in the Lyons review and taken forward in the 2004 spending review, will provide real opportunities for sustained job relocation inside the United Kingdom, and I am sure that that will be applied to his constituency as well.

Train Derailment (Ufton)

Alistair Darling: With permission, Mr Speaker, I would like to make a short statement on the train derailment that occurred at the Ufton level crossing in Berkshire on Saturday evening.
	As the House will be aware, at approximately 18.11 hours, the 17.35 First Great Western service from Paddington to Plymouth hit a car, which had stopped on the railway line at the level crossing at Ufton lane. There were approximately 180 passengers and four train crew travelling on the train. The train driver, the car driver and five passengers died and 37 people were admitted to hospital. Hon. Members on both sides of the House will wish to join me in expressing our deepest sympathy to the families and friends of all those who lost their lives and to those who were injured.
	I would like especially to praise the work of the Thames Valley emergency services and the agencies who worked closely together to respond to the accident with well-prepared contingency plans. I am told that the first of the emergency services arrived at the scene of the accident within four minutes. We must also thank the staff at the Royal Berkshire hospital and North Hampshire hospital for their care and dedication.
	The British Transport police immediately began an investigation into why the car stopped on the level crossing and the actions of the driver. Alongside the police investigation, Her Majesty's railways inspectorate carried out its investigation to determine whether the rail safety equipment at the crossing functioned correctly, and as a result of that, the Health and Safety Executive has produced an interim report, published this morning, setting out its findings. Copies of that report have been placed in the Library and are publicly available.
	It may be helpful to the House if I quote from the summary of the HSE report, which sets out what it has found. It says:
	"HSE investigators have not found any evidence at this stage to suggest that there were any errors by railway staff or faults with the level crossing, the signalling system or the train involved in the incident.
	Early indications are that a car driver stopped his vehicle on the crossing before the barrier sequence commenced and made no attempt to leave the vehicle once the crossing traffic signals began to flash and the barriers descended.
	The train struck the car. Damage to the crossing surface and sleepers between the crossing and 979 points"—
	that is the points at the entry to a goods line, about 100 yd from the crossing—
	"indicates that the leading wheelset of the train derailed at the crossing and the train travelled in that condition until reaching the points. The derailment was then exacerbated as the train passed over the points".
	The report sets out the HSE's findings in some detail and concludes:
	"The HSE investigation has not found any evidence in any of the level crossing or train data downloads to suggest any fault in the signalling, level crossing or on train equipment, or with the actions of those personnel on duty."
	The HSE has now completed its on-site investigation and withdrawn from the site, but it will if required support the British Transport police investigation as it continues.
	The next stage is for the Rail Safety and Standards Board, which has started a formal rail industry inquiry into the incident. A panel of independent experts will consider all aspects of the derailment. They will report within the next six to 12 months, but if any matters of importance on safety arise from their investigations, they will make them known immediately so that the appropriate action can be taken. It is for the coroner to determine the precise cause and circumstances of the deaths of those involved and I understand that the coroner's inquest will open today.
	I should like to consider what is being done in the meantime to help those who were in the accident and to resume services on the line. In the past, there has been concern about a lack of clarity on what is done in the aftermath of such an accident to help those who were involved.
	Network Rail and the train operating company, First Great Western, are working closely together to help those who were in the accident and their families. First Great Western has already taken the lead on handling claims from passengers. It is trying to contact all those who were on the train. There is a number to call for those passengers who have not already been contacted by the company.
	Network Rail has estimated that, because of the damage to the track, it will take at least a week to replace the track and signalling equipment. In the meantime, First Great Western has provided replacement bus services. Network Rail is doing all that it can to restore the service as quickly as possible.
	It is clear that this was a tragic accident. We owe it to those who were involved to find out the circumstances surrounding it. The inquiries that have been put in place will try to achieve that. It is ultimately a matter for the coroner to determine the cause of the tragic deaths.
	It is clear from the HSE interim report that there was no failure of equipment. However, if there are wider safety lessons to be learned, that is for the RSSB inquiry to establish and for the industry and the Government as necessary to pursue.

Tim Yeo: I thank the Secretary of State for sending me a copy of his statement an hour or so ago. Our first thoughts are for the families of those who lost their lives in the serious and tragic accident. I extend our deepest sympathy to the family of driver Stanley Martin, who died doing his job, the families of the others who died and the passengers who travelled last Saturday, expecting their journey to be safely completed. We also sympathise with all those who were injured and suffered the horrifying and inevitably frightening experience of being involved in a serious accident.
	I join the Secretary of State in paying tribute to the emergency services, which responded quickly and superbly in the difficult conditions that prevailed at the scene, and the staff of the Royal Berkshire and North Hampshire hospitals. I welcome the publication of the Health and Safety Executive interim report this morning. I look forward to the results in due course of the formal inquiry that the RSSB is conducting.
	The HSE report states that both the staff and the equipment that the railways used functioned properly. Knee-jerk reactions or hasty conclusions are the last thing that the railways and the travelling public need. However, several questions arise. I appreciate that the Secretary of State may not be able to answer them immediately but I would be grateful for his assurance that they will be considered at the right time.
	First, we must determine whether there are any lessons to be learned about the design of level crossings, especially whether the half barrier design, which appears to have operated safely at many crossings for a considerable time, can be improved in any way. Will the Secretary of State confirm that the last comparable accident that involved a level crossing with barriers happened as long ago as 1986?
	Secondly, given that modern technology is better and cheaper than what was available in the past, we must consider whether more use can be made of closed circuit television to provide train drivers and signalmen with more advance information about when lines may be blocked. Can the Secretary of State say whether we know yet how long the vehicle was on the tracks before the train struck it?
	Thirdly, are there any lessons to be learned about the design of trains, including the protection for drivers, who are now positioned at the front of high-speed and heavy trains, and the interior of carriages—the positioning and angle of seats and other internal fittings? Is there any evidence in this country or abroad that the use of safety belts in trains would be a practical or effective way of reducing the risk of injuries? Does the Secretary of State share the widely held view that it is not practical or cost-effective to replace all level crossings on high-speed lines with tunnels or bridges, as one trade union leader suggested the morning after the accident?
	Does the Secretary of State agree that, if any steps can be taken to make trains, which despite the tragedy are one of the safest ways to travel, even safer, they should be carefully considered but that any action or expenditure should always be proportionate to the risks and analysed for their cost effectiveness?

Alistair Darling: I am sure that the relatives of those who were killed or injured and the injured themselves will be grateful for the hon. Gentleman's remarks. I very much appreciate the measured response of the hon. Gentleman and many others in the aftermath of the accident. He asks number of questions. All these matters will be considered by the inquiry, as the House would expect, but it might be helpful if I make one or two observations.
	Most level crossings on high-speed lines—that is, the east coast line, the west coast line, the midland main line and the great western line—have full barrier crossings. There are about 16 crossings on those lines which have the half-barriers, but that is where there are line speeds of 100 mph or less. The line speed on the line in question was 100 mph. I must tell the House—I think the hon. Gentleman appreciates this—that the evidence so far is that the car was already on the track before the barrier sequence started. He asks how long it was on the track. The British Transport police are still investigating that and I do not want to say anything further. It is pretty clear that the car was already on the track, so it was not the case that the barrier was there and somehow the driver got round it. That is obviously one of the aspects that will have to be examined.
	There are about 8,000 level crossings across the whole network. About 1,700 are barriers and lights, the sort that we are discussing. Network Rail, which owns the track, reviews all the crossings regularly. The last time there was a safety assessment on this crossing was 8 July this year, when it was examined and assessed. People should be aware that these things are kept constantly under review.
	The hon. Gentleman asks about design and seat belts. That has been and will be considered. The new trains that are coming into service now are much better constructed than, for example, the old slam door trains that are being taken out of service. Of course attention is paid to interior design and so on. The question of seat belts has been considered both in Britain and in countries throughout the world, but so far there has been a general reluctance to pursue the idea. The issue undoubtedly needs to be looked at again. It is not straightforward, not least because of the fact that people tend to move around trains. Anyone who has been on a train knows that they are not the same as an aeroplane, where people tend to stay seated.
	The final point that the hon. Gentleman makes about safety and costs is an important one. When we approach these matters, we should ask ourselves what is best in relation to safety. It was a terrible accident, but we should bear it in mind that rail safety in this country has been improving year by year. It is worth noting that in the past year, when the railways carried a record number of people—the highest number since the 1940s—there had not been an accident involving railway passengers. Sadly, there are accidents around the tracks, but those are other issues that we may explore today and which we need to examine. Nevertheless, the hon. Gentleman has my assurance that the matters that he raised will be looked at.

John Thurso: Our first thoughts today must be with all the victims of the tragic accident—those who lost their lives and those who were injured. May I, therefore, associate myself with the remarks of the Secretary of State and those of the hon. Member for South Suffolk (Mr. Yeo), and pass on our expression of deepest sympathy and condolence to all the relatives of the bereaved? May I add our tribute to the work of the emergency services and staff of the hospitals involved, who acted with commendable dispatch and in the finest traditions of our emergency services? I thank the Secretary of State for his courtesy in sending me an advance copy of his statement.
	The key paragraph in the interim report, from which the Secretary of State quoted, is paragraph 17 on page 5, which makes it clear that there was no failure of systems, management or staff that was responsible for this tragic accident. There are clearly issues to be resolved by the police investigation in respect of the car and how it came to be there and, as the right hon. Gentleman mentioned, in respect of any wider safety issues that may have to be considered in due course, particularly with regard to level crossing design. However, today is not the day to debate these issues, and I would merely ask the Secretary of State to undertake to return to the House when the appropriate moment arises, so that we may have a debate at that time.
	Finally, will the Secretary of State reiterate that, notwithstanding the tragic events that took place last Saturday, the railways remain an extremely safe mode of travel, and one in which the travelling public can have confidence?

Alistair Darling: Again, I appreciate what the hon. Gentleman has said, and the way in which he said it. On his final point, it is worth reminding ourselves that, notwithstanding this accident, the railways are safe. We should all reflect on the fact that, over this last weekend, for example, 10 people were killed in road accidents. While we are doing everything that we possibly can to improve rail safety, we should also bear it in mind that a lot remains to be done in relation to road safety as well. As I said a few moments ago, we shall certainly look at these matters, and when we get the final report, I have not the slightest doubt that we shall return to it.

Martin Salter: The Secretary of State will be aware that the crash took place at a site very close to three parliamentary constituencies that I know extremely well. While it is important to await the outcome of the full investigations by the RSSB, and not to jump to any premature conclusions, will he ensure that consideration is given to any devices that could be installed to give train drivers advance warning of any obstruction of railway lines at unstaffed level crossings? These could include CCTV, or pressure switch devices that could be triggered by a heavy blockage on the line.

Alistair Darling: This is clearly something that the RSSB will look at. However, as I have been saying over the past few days, we do not yet know how long the car had been on the line, and I would not want people to think that there were devices that could prevent all eventualities. This train was travelling at about 100 mph and, even with emergency braking, it would take between half a mile and a mile to stop. Obviously, the industry will look at the technology that is around and, importantly, at the technology that is being developed. What we want to do all the time is make things as safe as we possibly can. Our great difficulty, however, is that in an open network—as a railway system inevitably is—if somebody really wants to get on to the track, we cannot exclude every possibility of that happening, even if we do everything that we can.

John Redwood: The local community is very shocked by this dreadful accident, and I would like to send my deepest sympathy to the families of all those who have lost loved ones, and to the   injured. I would also like to add my thanks to the emergency services and the members of the local community who responded magnificently when the crash occurred. Will the Secretary of State give me his personal assurance that the safety concerns that I sent to the HSE again this morning will be properly considered, including the question of whether more safety features can be built into the future design of railway carriages? Many of the injuries in this crash occurred under rapid deceleration as people and luggage were detached from where they should have been.

Alistair Darling: I am sure that everyone involved in the accident will appreciate what the right hon. Gentleman has said. He is particularly right to draw our attention to the help that was so promptly and readily given by people living and working near to the accident site on Saturday evening. And, yes, I can assure him that the suggestions that he has made to the HSE this morning will be taken into account. As I said a few moments ago, a lot of attention is given to safety features on each new generation of trains, in regard not only to the structure of the carriages but to the internal fittings. For example, the refurbishment of the east coast main line fleet that is taking place at the moment has taken into account some of the things that have happened in previous accidents, in terms of the internal design of the carriages.

Clive Efford: This accident happened in the most extraordinary circumstances, and I am sure that we all join together in sending our sympathy to all those who have been affected. In answer to my hon. Friend the Member for Reading, West (Mr. Salter), the Secretary of State said that we did not know how long the vehicle had been on the tracks. We all understand that, but each occurrence such as this could bring to light loopholes in the safety systems that we need to close. Will my right hon. Friend give us an assurance that the HSE will investigate all the available forms of technology that could be used to identify blockages at unmanned level crossings, so that we can establish as early a warning system as possible? We must bear it in mind that such a system might not have prevented this accident, but we might be able to identify a problem that can be resolved for the future.

Alistair Darling: The RSSB will examine such matters, and the Health and Safety Executive will help it. My hon. Friend is right that we must consider what technology might be available now and in the future, not just for new but existing trains. As I said, each year, further improvements come along. For example, the vast majority of trains are now fitted with the train protection warning system, which was not the case a few years ago. This train was fitted with that, but it did not help in a situation in which the signals were all at green and the car was on the railway line at some point. His general point, however, will be considered by the inquiry.

David Rendel: Two of those who died were my constituents, one of whom I knew personally, and a number of other constituents were on that train or helped in the aftermath of the incident. I am grateful to the Secretary of State and other Members for offering their condolences, as I am sure that my constituents will be. Does he agree that it would be sensible in future for the emergency procedures to include some method of making sure that we get hold of the names and addresses of all those involved, since it appears that that did not happen on this occasion. At least we could then offer them help afterwards, if there are opportunities to do so, or ask them any further questions.
	Is the Secretary of State also aware that in coach E, when an attempt was made to break the windows, the hammers broke, not the windows? That is thought to be because they were being improperly used, or not used in accordance with safety instructions. Of course, safety instructions are often ignored by people until they are in an accident, but when it happened, the lights went out, and there was no emergency lighting to enable the safety instructions to be reviewed. Would it be possible to try to make sure that train companies introduce emergency lighting, at least where the emergency equipment is kept?

Alistair Darling: I am sure that the inquiry will consider that. The hon. Gentleman will be aware that in this case, because of the way in which the train eventually stopped, many of the power lines would have been fractured. He will have seen the photographs that show what happened to the train when it stopped I am sure that the inquiry will want to examine the use of hammers in particular.
	I understand that the decision on names and addresses is essentially one for the coroner, and that certain formalities must be observed, such as formal identification. I am sure that the hon. Gentleman will agree that the last possible thing that we want is the wrong names and addresses. If anything can be done to speed up that process, I am sure that it can be examined. I know that there was a slight delay on this occasion, and I will have to make further inquiries about the reason for that, but those are essentially matters for the coroner and police.

Gwyneth Dunwoody: In a horrific incident of this kind, the shattering effect not only on the family of those involved but on those working on and around the railway lasts for a very long time. I know that the Secretary of State will consider carefully the physical means of slowing down a train, but the reality is that that would have been almost impossible for a train at that speed. The unfortunate juxtaposition of the points was among the factors that contributed to the accident. Will he assure me that the families concerned, the people involved and some members of the emergency services will continue to receive not only information but help in the coming months, when they will desperately need it?

Alistair Darling: I attach some importance to that as, having met those who were affected by some of the major rail accidents that happened before I was Secretary of State, it is clear to me that what is important, among many other things, is that people are kept in touch and that they understand what is going on. That is why I was keen to ensure that both Network Rail and First Great Western, which will take the lead in this since it was its train, should get in touch with people and deal with their immediate concerns, as well as concerns that will probably arise over the next few weeks and months.
	My hon. Friend is also right that we should not forget what a traumatic experience this is, not just for the railway staff but for everybody who has any involvement. Sadly, every year, a large number of incidents take place, which obviously can be tragic for the people involved, but which can also have a traumatic effect on railway staff. People sometimes forget how much trauma that causes for such staff. It must be remembered, primarily by their employers but, by others too.

William Cash: Will the Secretary of State accept that in my constituency, which has probably the highest number of level crossings in the country, there is deep concern about the safety issues, to which I referred in an Adjournment debate some time ago? In Barlaston, the level crossing failed seriously a few days ago, which is of grave concern to local residents. It should not be assumed that the funding is adequate to deal not only with the new technologies to which he has referred but with the necessity in certain cases for tunnels or bridges. That is not a knee-jerk reaction, as in certain cases it may be essential: for example, in Hixon in my constituency, where there was a fatality recently, and where, fortunately, a bridge has now been built.

Alistair Darling: In relation to the hon. Gentleman's first point, I am not aware of the problem that arose on the level crossing to which he refers, but if he would care to identify it in a little more detail, I will find out and write to him, and the letter will be placed in the Library so that people can appreciate the position. Inevitably, level crossings present a risk—anyone being on the track presents a risk. The object must be to try to manage that risk as much as possible. It is worth bearing it in mind that only twice in the past 35 years has there been an incident at a level crossing on a main line that has resulted in the deaths of railway passengers. Undoubtedly, every year, there are cases involving pedestrians and motorists, which are sometimes accidents and, unfortunately, sometimes suicides. In each case, we must try to manage the risk as much as possible. In the past couple of years or so, Network Rail has taken nearly 200 level crossings out of service where it was appropriate and where there was a realistic alternative, which is not always the case.
	Finally, I am aware of cases where we would like to spend money and do something, but where other objections must be dealt with, such as environmental objections—I can think of one crossing in particular in that regard. None of these issues is straightforward, but of course we must keep them under review. As I said in reply to the hon. Member for South Suffolk (Mr. Yeo), each crossing is reviewed regularly.

Lawrie Quinn: May I associate myself with the Secretary of State's remarks about the emergency services and the wider railway community? As someone who previously had responsibility for many level crossings in the east of England, it is only too clear to me what may have happened in this case, although it is right to wait for the inquiry. Having said that, can he say whether any messages are coming back from the industry, particularly Network Rail, with regard to track-side and driving cab radio-controlled systems, to see whether we can improve the mechanism for getting such information to drivers?

Alistair Darling: I know that my hon. Friend knows a great deal about this, as before coming to the House his job was very much involved with railway engineering. Network Rail has a project that will allow mobile phone communication between the cab and signallers. Again, that is not without difficulty, and some Members, for understandable reasons, are concerned about the placing of the radio masts that must go with such projects. We must deal with that.
	I ought to say—I know that my hon. Friend knows this—that from what we know about this case so far, it seems clear that although an off-duty police officer phoned the signal box, no matter what means of communication he had, it was so late that it would almost certainly not have stopped this train, simply because of the speed at which it was travelling. From the time that the barriers come down, there is about 30 seconds, and such trains, by their very nature, take some time to stop. In relation to his general point about increased communication, however, that is in hand. In this case, however, from what I can see, it would not have made much difference.

Adrian Sanders: The 17:35 Paddington to Plymouth train could not have had a more experienced driver than my constituent, Mr. Stan Martin from Torquay. Will the Secretary of State do all in his power to ensure that those who work on our railways, and their families, realise that safety will remain the primary concern of the railway industry?
	Will the Secretary of State join me in paying tribute to the 14-year-old Torquay schoolgirl who used her Red Cross skills to nurse and comfort Louella Main, the nine-year-old victim of the crash? The teenager and her mother, who tried to help the child as she lay in a field next to the crash scene, have asked for their names not to be used out of respect for those who did not survive the tragedy.

Alistair Darling: The hon. Gentleman draws attention to one of a number of extremely courageous and thoughtful actions on the part of not just passengers but others in attendance. Many people performed heroic deeds, but for perfectly understandable reasons that will go unremarked, in that their identities will not be known. That is a tribute to their humanitarian feelings, and the hon. Gentleman was right to draw attention to it. He was also right to draw attention to the skill of the driver who died. The HSE report makes it clear that he did everything he was supposed to do in the event of an emergency. Sadly, however, he lost his life.
	As I said a few moments ago, we should always bear in mind the skill of many people working on the railways who ensure that the system is safe and that rail is a safe means of travel.

Chris Bryant: It would clearly be wrong to jump to any conclusions about precisely what happened on Saturday evening, but every Member who has spoken so far has described it as an accident. It is perfectly possible that it was no accident, but a deliberate act of violence and self-violence. Unfortunately, as the Secretary of State has said, suicides on the railway are relatively common, bringing not only tragedy to the families involved but a great deal of pain and personal anguish to drivers and many other people. Will the inquiry consider what we can do, as far as is humanly possible, to try to prevent further such suicides?

Alistair Darling: My hon. Friend raises two separate issues. As he says, we should not reach conclusions before they are warranted by an examination of the facts, which will be undertaken by the Rail Safety and Standards Board. As for the precise cause of the accident, that is something that the coroner will determine.
	My hon. Friend made a more general point about suicides on the railway, of which there are between 180 and 200 a year. The Department, along with the industry, is already giving attention to that, but as I said earlier, it is impossible to stop people getting on to the track if they really want to. We must see what we can do to reduce the risk and improve the situation. No one could claim that such actions will be impossible in future—that is simply not the way the world works—but I hope the work done by the Department and the industry will help.

Bob Spink: Will the Secretary of State confirm that, sadly, up to four people a year die on unmanned pedestrian level crossings, and that it is Government policy to close such crossings where it is reasonable to do so? A few hundred yards up the road from the Benfleet pedestrian crossing is a perfectly safe alternative in the form of an underpass. Closing crossings of that kind would be very much in the interests of public safety, and would solve the problem of noisy train whistles.

Alistair Darling: The hon. Gentleman has raised that issue in the House before. I believe he initiated an Adjournment debate on the subject fairly recently.
	Network Rail's policy is to remove level crossings when that is practical and the right thing to do, but the process is not without difficulty. Throughout the earlier months of this year, in a different part of the world from that represented by the hon. Gentleman—the highlands of Scotland—there was a sustained campaign against Network Rail's attempt to remove a number of unmanned crossings, led by walkers who, for entirely understandable reasons, wanted to be able to cross on foot. A sensible balance is needed. Those who remove crossings should make certain that people will not take matters into their own hands and cross the track by, for instance, climbing over a fence. It is fine if there is a sensible alternative.
	A remarkable number of people try to zig-zag through barriers or jump the lights. They must understand that they are putting not just their own lives but those of others at risk. In my opinion, such behaviour should never be tolerated.

Paul Tyler: My constituents who use the line regularly—as I do myself—will appreciate the Secretary of State's measured report, and the measured response of other Members. May I, however, encourage the right hon. Gentleman to emphasise that this was a maverick tragedy? Is it not important to convey to the travelling public the figures that he cited earlier, relating to road and rail safety respectively? He pointed out that last weekend—tragically—there were 10 fatalities on our roads. May I suggest that the approach he has taken today must be the approach taken by the further inquiry, and that cost-benefit must be part of the balancing act? If we lose our sense of proportion, the travelling public will gain a completely false impression.

Alistair Darling: I agree with much of what the hon. Gentleman has said. We need to draw our conclusions in a measured way, and decide what is right and appropriate. We should indeed remember that, sadly, every day—not just last weekend—10 people are killed on the roads. Our road safety record is much better than those of many other European countries, but 10 people are still 10 too many. We need to reduce the risk by doing whatever is appropriate. We also need to bear it in mind that the cause of many accidents is not something that the Government of the day did or did not do, but the judgment of some individual. We can all make the wrong judgment when travelling, I suppose. As I have said, however, we must do all that we can to improve the safety of all travellers—those who travel by road, rail or, for that matter, air.
	The hon. Gentleman was right to remind us that rail is a safe means of travel, and it is becoming safer each year. Tragically, there are accidents from time to time; but it is still a safe way to travel. I have no doubt that when the line reopens, hopefully in the next week or so, many will continue to use it to travel to the south-west.

Adrian Flook: Many of my constituents use the service, and a friend of mine was trapped and injured on Saturday evening. Mercifully, she is now back at home. I echo the thanks that have been expressed to the emergency services, and especially thank the off-duty firefighter and the off-duty Royal Marine who helped my friend at her moment of need.
	We have already heard how safe rail is in comparison with roads. May I have an assurance that any response to this tragic crash will not lead to a lessening of the frequency or speed of the service from the west country to London?

Alistair Darling: I do not want to pre-empt the inquiry, but the tenor of what has been said this afternoon suggests that whatever we do must be proportionate. We want to make the system as safe as we can, but travelling at speed inevitably involves a degree of risk. I think people recognise that. From the moment we set out from our front door we incur an element of risk, and arguably that is the case when we are in our homes.
	The hon. Gentleman was right to draw attention, as others have, to the heroism and humanity of a very large number of people on Saturday evening.

Bob Russell: I thank the Secretary of State for emphasising that rail is a safe way in which to travel. May I urge him, and his ministerial colleagues, to repeat that message as often as possible? I fear that media coverage has given the impression that rail travel is not safe, but will he confirm that the number of people who die in rail-related incidents each year represents about two days of road fatalities? Will he also confirm that in the last year for which figures are available, on 280 days the number of people killed on the roads was seven or more?

Alistair Darling: The hon. Gentleman is right to draw attention to the fact that far too many people are killed and seriously injured on our roads. He is also right to say that the number of people killed on the railways has been declining over the past 30 years. Thankfully, the number is comparatively small, although it is a tragedy for everyone who is involved.
	There has been a measured response from everyone today. The hon. Gentleman mentioned the media. I do not suppose that it will do me any good, but I believe that their response after the accident has, for the most part, been measured. They are saying, "You must learn the lessons of what happened. You must do things, and you should react proportionately." Most commentators, from the moment the accident happened, have taken a sensible and mature line in the face of what is, after all, an extremely tragic accident.

Anne McIntosh: May I associate myself with the comments of the Secretary of State and of my hon. Friend the shadow Secretary of State? What is particularly poignant about the timing of the accident is the fact that we had almost had a record period in which there was no rail accident or incident. I have had the honour of spending some time with Network Rail on the Industry and Parliament Trust scheme. I hope that the Secretary of State will take the opportunity to confirm that, with the dent in morale that anyone working in the railway industry will feel at this time, the thoughts of the House are with them.
	There is another alarming feature in respect of those who were trapped in the train. The doors on these sophisticated modern trains open only when the train arrives at the scheduled station—they are computer-driven. It was particularly distressing in that many of the injured could not exit through the normal door. Will the inquiry look at that?

Alistair Darling: I am sure that the RSSB will look at the latter point. I am not qualified, and nor is anyone else sitting in the Chamber, to pass judgment on that. It needs to be looked at. The hon. Lady is right. We had a long period without accidents, and everyone in the industry can be extremely proud of that. A lot of attention has been paid to safety.
	The hon. Lady has been on the Industry and Parliament Trust scheme. Morale in the industry is slowly but surely improving. For various reasons, it has been through a difficult time—there have been some accidents in the past few years, but there are other reasons, too. People can be proud to work in the industry. I encourage people to do so. Above all, I encourage people to use it because it is pretty good most of the time. Of course, there are problems, which we need to sort out, but it is improving in a way that perhaps people would not have thought possible a few years ago.

Julian Lewis: The hon. Member for Rhondda (Chris Bryant) was surely right in drawing attention to the fact that this may not have been an accident—it may have been deliberate. In a week when the director general of the security services has warned us against complacency, and bearing in mind the train bombings in Spain during the election campaign, does the Secretary of State think that, in considering what level of investment is proportionate, we must take into account the fact that there is at least a possibility that this event will encourage some people who wish to engage in serious terrorist acts to do this sort of thing deliberately?

Alistair Darling: Nothing will be served by such speculation. I repeat what I said earlier: it is for the coroner to determine the cause of death, not just of the car driver but of the other people who died in the accident.

Alcohol-Related Anti-Social Behaviour and Domestic Violence

Andrew Turner: I beg to move,
	That leave be given to bring in a Bill to amend the law relating to Anti-Social Behaviour Orders to extend their application to cases of domestic violence and alcohol-related disorder
	The Bill is designed to prevent violence, especially domestic violence. Alcohol is a key contributor to domestic violence. It increases both the risk of violence and its severity. If we stop excess drinking among men—it is usually men—who, when drunk, are likely to be violent, we can reduce violence. This Bill enables the police to act against such drinkers before they resort to violence.
	The relationship between alcohol and domestic violence is stark. The Home Office document, "Alcohol and intimate partner violence: key findings from the research" finds strong links between domestic violence and "problem" drinking. The British crime survey told us in 1999 that 32 per cent. of domestic violence was perpetrated under the influence of alcohol. It estimates that there were around 1.2 million incidents of alcohol-related violence in 1999. Those include all assaults, robberies and snatch thefts in which the victim thought the perpetrator to be under the influence of alcohol. A quarter of those—300,000—were domestic assaults.
	The likelihood and severity of violence is linked to the amount drunk. Alcohol is especially important in inflaming existing conflict. Repeat victimhood is common. Forty-five per cent. of victims of domestic violence have suffered before. According to the Home Office's women and equality unit, 35 per cent. of incidents of domestic violence take place within five weeks of an earlier attack. No other type of crime has such a high rate of repeat victimisation.
	An article in 2001 in the Journal of Interpersonal Violence tells us:
	"Studies suggest that between 25% and 80% of domestic violence perpetrators abuse alcohol and these rates of alcohol abuse and dependence are two to seven times higher than rates in the general male population."
	In a study of 100 "battered women", as they used to be called, published in the British Medical Journal in January 1975, 52 per cent. of offending males were described by their victims as "frequently drunk", and a further 22 per cent. as having
	"episodes of heavy drinking with drunkenness".
	Let me give the House an example. Gabbi Millar, the manager of a women's refuge, was beaten by her alcoholic former husband for four years before she finally plucked up the courage to leave him. She told the BBC in June 2003:
	"When he was drinking, I wasn't allowed to go to sleep; I had to stay awake with him. It was sleep deprivation, something which happens a lot to victims of domestic violence . . . I really did think he would end up killing me. The level of violence only ever gets worse."
	During a period of 18 months, the police were called to the family home 36 times, either by Gabbi, or by worried neighbours who heard her cries for help. During their four years together, her husband was jailed three times for the escalating offences of assault, actual bodily harm and grievous bodily harm. Gabbi was in hospital three times after particularly severe beatings and I regret to say that I have observed a similar relationship between alcohol and domestic violence reported in the pages of my own Isle of Wight County Press.
	Recently, the law has been tightened significantly to deal with the perpetrators of domestic violence. The Domestic Violence, Crime and Victims Bill makes it a criminal offence, punishable by up to five years in jail, to breach a non-molestation order. It requires courts to consider making a non-molestation order when they hear an application for an occupation order. Such orders exclude someone from the home and surrounding area, but breach of an occupation order is not a criminal offence. The Bill enables courts to impose restraining orders when sentencing for any offence—at present, they can be imposed only when sentencing for harassment—and common assault will be made an arrestable offence.
	Those changes are welcome, but that Bill does not adequately deal with the role of alcohol. It appears to be hoped that its penalty provisions will deter domestic violence, but the deterrent may not work where alcohol is a factor, since deterrence requires an individual to be rational. Not only is alcohol a disinhibitor, but an individual's capacity for reason is greatly reduced when under the influence of alcohol, so any deterrent would also be reduced.
	We need to prevent men who might hit their womenfolk from becoming drunk enough to do so. Antisocial behaviour orders could help us. The courts can impose one if persuaded, on a balance of probability, that a person has acted in an antisocial way and that an ASBO is necessary to prevent further antisocial behaviour. Breach of an ASBO is itself a criminal act.
	At present, ASBOs cannot be applied to domestic violence because antisocial behaviour is legally defined to affect only
	"persons not of the same household".
	The Metropolitan police, in their December 2001 domestic violence strategy paper, "Enough is Enough", discuss one suggestion for using ASBOs against domestic violence. They say:
	"It is suggested by the CPS that Anti-Social Behaviour Orders (ASBOs) may be used against domestic violence. ASBOs relate to behaviour that 'is likely to cause harassment alarm or distress to one or more persons not of the same household'. In the context of domestic violence this could relate to harassment caused to neighbours. By considering the use of ASBOs in this way it could send a message to the perpetrator that domestic violence is considered unacceptable to the local community and provide alternative options for the victim."
	In my view, that is too roundabout a route. Of course domestic violence is unwelcome in the community, but it would be absurd to limit what could be an effective preventive measure to households whose neighbours are affected.
	ASBOs could certainly help to prevent alcohol-related domestic violence if they could reduce the volatile circumstances in which it flourishes. The trigger of alcohol needs to be effectively removed, so my Bill offers a simpler solution than that proposed by the Metropolitan police. It would widen the definition of antisocial behaviour to include the domestic, thus enabling the courts to issue ASBOs in cases of domestic violence. It would allow an ASBO, where appropriate, to require the subject to remain under a set alcohol limit. The court could have discretion to limit an order to certain times, places and circumstances, for instance if previous problem drinking and violence had taken place only at night. Neighbours, if not the victim of violence herself, might call the police when they feared an alcohol-related ASBO was being breached—hopefully, in time to prevent violence.
	This alcohol-related ASBO would not only be available in cases of domestic violence but could extend to other alcohol-reduced disorder, such as that which too often takes place after closing time in our urban areas.
	The Bill would permit the police to administer a breath test, as in cases of suspected drunken driving, if they believed that the alcohol-related ASBO had been breached in circumstances where the subject was likely to commit another offence.
	Too many of those who hit their wives or girlfriends do so under the influence of drink. Too many of those who commit other offences, and disfigure our towns and cities as they do so, are in drink. The forces of law and order have at their disposal many ways of dealing with the guilty, but as a society we have too few means of preventing these crimes. We have successfully reduced drunken driving by use of the breathalyser. Let us do the same with alcohol-related disorder, which probably causes as much, albeit sometimes lower-level, misery.
	Prevention is better than cure. Prevention is the objective of the Bill, and it is with pleasure therefore that I commend it to the House.
	Question put and agreed to.
	Bill ordered to be brought in by Mr. Andrew Turner, Mr. Frank Cook, Jane Griffiths, Mr. David Wilshire, Mr. David Drew, Mr. Robert Key, Mr. Robert Walter, Mr. Paul Burstow, Sir Sydney Chapman, Mr. Andrew Robathan, Jim Knight and Angela Watkinson.

Alcohol-Related Anti-Social Behaviour And Domestic Violence

Mr. Andrew Turner accordingly presented a Bill to amend the law relating to antisocial behaviour orders to extend their application to cases of domestic violence and alcohol-related disorder: And the same was read the First time; and ordered to be read a Second time on Friday 19 November, and to be printed [Bill 177].

HUMAN TISSUE BILL (PROGRAMME) (NO. 2)

Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 6 November 2003],
	That the Programme Order of 15th January 2004 be supplemented as follows—
	Consideration of Lords Amendments
	1. Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion at 7 p.m. at this day's sitting.
	Subsequent stages
	2. Any further Message from the Lords may be considered forthwith without any further Question being put.
	3. The proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.—[Joan Ryan.]
	The House divided: Ayes 304, Noes 110.

Question accordingly agreed to.

Orders of the Day
	 — 
	Human Tissue Bill

Lords amendments considered.

Clause 5
	 — 
	Prohibition of activities without consent etc.

Lords amendment: No. 1

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this we may discuss Lords amendments Nos. 2, 10 to 17, 34, 35, 37 to 39, 50, 51 and 53.

Rosie Winterton: These Government amendments were introduced to meet the concern expressed in the other place that giving magistrates the power to send researchers to prison conflicted with the Government's having stated that only the most serious offences would warrant a custodial sentence. The penalties available to magistrates relating to offences under the Bill were considered excessive, since the most serious cases would be referred to the Crown court anyway, so there was wide support for the view that fines should be a sufficient penalty for magistrates to impose in dealing with these offences.
	The new offences created by the Bill are, in the jargon of the criminal justice system, triable either way; in other words, they can be dealt with by magistrates or by the Crown court. The amendments remove the scope that clauses 5 and 8 provide for magistrates to order a custodial sentence following summary conviction for offences relating to consent and to misuse of human tissue; the scope that clauses 25, 30 and 31 provide for such a sentence in respect of licensing offences; and the scope that clause 50 so provides in respect of the DNA offence.
	We have not removed magistrates' power to order custodial sentences for all offences under the Bill because they can already order such sentences for most offences under the Human Organ Transplants Act 1989, which is concerned with trafficking in human organs and live transplants. They will continue to be able to do so for all offences transferred to the Bill from that Act.
	The consequential amendments to clause 63 relate to the position pending the coming into force of the Criminal Justice Act 2003, and the consequential amendments to clauses 56 and 64 relate to the position in Scotland and Northern Ireland.
	I have made it clear in this House, as did my noble Friend in the other place, that the penalties are there to act as a deterrent to future offences relating to consent and misuse of human tissue. We do not expect cases to come to court. The effect of the amendments will be, for example, that where a person stores or uses tissue taken from a deceased person for quality assurance without consent, if they are prosecuted and magistrates hear the case, the maximum penalty will be a fine. If the offence is so serious that the magistrates refer it to the Crown court, or if the defendant chooses to have a trial by jury, he or she can be sent to prison.
	In introducing these amendments, we have responded to some of the concerns raised in the other place on behalf of researchers and pathologists. I therefore urge the House to accept the amendment.

Andrew Lansley: I am grateful to the Minister for explaining the purpose of the amendments tabled in the other place, though she will be aware that concerns were raised in Committee on 29 January. I made it clear then that we were surprised at the severity of the penalties and I argued that the provision for 12 months' imprisonment on summary conviction or three years on indictment seemed excessive. Happily, the Minister's colleague undertook to take the issue away for further consideration. It was not subsequently resolved in this House, but I am glad that it has been resolved in the other place.
	Given our experience of the Human Organ Transplants Act 1989 and the availability of penalties to act as a deterrent there, the Lords amendment poses some questions. I was not aware of any concerns arising from consultation on the Bill about the lack of available penalties under earlier legislation or any abuse resulting from it. It seems that increasing the severity of penalties is not really needed in the Bill. None the less, I entirely take the point that the purpose of the penalties is to act as a deterrent. They will clearly do so because they are relatively severe.
	My hon. Friend the Member for Westbury (Dr. Murrison) reminded me that, for those who are medically qualified, even the penalties relating to summary conviction and a fine before a magistrate are likely to have professional consequences, so it is important to recognise that the penalties will act as a deterrent to contravening the legislation. As the Minister argued in Committee, we all hope that it will never be necessary to bring any cases to trial.
	My noble Friend Earl Howe raised some concerns and made it clear that we were unhappy about the prospect of prosecutions being brought before a magistrate and leading, on summary conviction, to imprisonment. Even though cases are triable either way and the defendant may elect for trial by jury, it seems inappropriate to implement such a procedure. I am happy that the Minister in the other place accepted that argument and that the Government tabled amendments to meet our concerns. We are content—indeed, pleased—that, in this respect at least, our concerns about penalties have been met.
	Lords amendment agreed to.
	Lords amendment No. 2 agreed to.

Clause 6
	 — 
	Activities involving material from adults who lack capacity to consent

Lords amendment: No. 3

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this we may consider Lords amendment No. 44.

Rosie Winterton: Lords Amendment No. 3 supplies a word in the Secretary of State's title in clause 6. I hesitate to say it, but it was spotted by eagle-eyed Opposition peers, though I am sure, of course, that it was also spotted by Opposition members of the Committee.
	Lords amendment No. 44 corrects a drafting omission, which should have been included in the Bill when amendments were made by the House on Report, allowing the use of material or DNA analysis in certain circumstances in court orders. Clause 57 deals with the secondary legislation to be made under the Bill, including parliamentary procedure and consultation processes that apply to it. Subsections (1) and (2) refer to
	"Any power to make orders . . . under this Act".
	That is clearly intended to refer only to secondary legislation but, as drafted, it could also apply to the powers of the court to make orders under clause 7 and schedule 5. It would clearly be inappropriate for a clause dealing with secondary legislation to apply to court orders, so the amendment ensures that that would not be the case.
	Lords amendment agreed to.

Clause 7
	 — 
	Powers of court to dispense with need for consent

Lords amendment: No. 4

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this we may consider the following: Lords amendments Nos. 4 and 5, Lords amendment No. 6 and Government amendment (a) thereto, Lords amendments Nos. 7 to 9, 52, 54 and 62 to 69.

Rosie Winterton: The Government introduced this group of amendments to clause 7 and schedule 5 in response to points raised in the other place about two issues. First, the amendments provide scope for orders to be granted to waive consent where people do not respond to requests for consent to use their tissue to inform the health care of someone else. Secondly, they take the power to make these types of order away from the High Court and give it to the Human Tissue Authority.
	The amendments were made in response to debate on a related amendment in Grand Committee in the other place. The Opposition tabled an amendment to introduce a court order to allow a refusal of consent to use tissue for the benefit of a relative to be overridden in prescribed circumstances—for example, in DNA analysis. The Government did not and could not accept that, since overriding someone's refusal of consent would cut directly across the basic principle of the Bill, which is that people should be able to decide what happens to their bodily material.
	The Government believe that overriding a refusal of consent in that way would be a step too far. We must establish systems, particularly in the sensitive area of genetics so that individuals are asked, when their tissue is taken, whether they are content for it to be used for purposes such as research or informing their families' care. We know that 99 per cent. of people will agree and we provided, when the Bill came to this House on Report, for a waiver of the need for consent in the case of "missing relatives", where the person whose tissue might be used simply cannot be found. However, the Government listened hard to the debate in the other place and discussed the matter further with key stakeholders in genetics, who are most interested in this issue. They suggested that, in reality, the need to override refusal was a very infrequent occurrence and, indeed, some agreed that such an order would not be justifiable.
	Geneticists say, however, that sometimes individuals just do not respond to requests for consent, so that they neither give nor refuse consent to the use of their tissue for the benefit of a relative. This situation arises in connection with requests to test tissue for genetic markers for various forms of familial cancer, such as breast and bowel cancer. I shall give a practical illustration of that.
	Let us say that a person's uncle has bowel cancer. If the nephew wishes to know whether he is at risk of getting the same disease, it may be possible to test an existing stored sample of the uncle's tissue to find out whether both people share a known specific genetic mutation. If the uncle agrees, then it is clear that tests can proceed. That will be what happens in almost all circumstances, as we know that people are generally happy to assist in that way, especially with diseases that may affect family members. However, the question arises about what we can or should do if such agreement is not given, either because the uncle cannot be traced—and we dealt with that on Report—or because he simply fails to respond to requests.
	At present, the common law on these issues is unclear, but in practice there is no clear legal obstacle to using material in this way without the uncle's consent. Clinicians usually try to get consent from relatives but, where that is not successful, they may seek to obtain tissue samples through the medical network without consent. We do not believe that that is satisfactory from any point of view, and part of the purpose of this Bill is to give certainty to these situations. However, the Bill means that the use of tissue for the purpose that I have described will clearly require consent, Geneticists say that, if individuals do not respond to requests to use their tissue for genetic comparison, their relatives may be refused prospective tests for genetic diseases by the NHS. Obviously, that could well cause distress and get in the way of treatment or prevention measures in individual cases. Without the right information, patients may not know whether to embark on a regime of regular tests, some of which—colonoscopies, for example—may be invasive.
	The Government decided to address this situation by extending the "missing relative" provision, in clause 7(1) and schedule 5(9), to these cases of "non-responding" relatives. These amendments therefore provide that, in such cases, as long as certain conditions set out in the amendments are met, the Human Tissue Authority can deem consent to be in place for the purpose of obtaining information to benefit a relative.
	In the example that I gave, the amendments would be able to deal with the situation where the uncle failed to respond to requests to use his stored tissue. If the uncle said no, that would be the end of the matter, but if he simply did not respond, the nephew could make an application under clause 7.
	The conditions for waiving the need for consent include the requirement that reasonable efforts are made to get the person to consent, and that the person involved is given notice of the application. The aim is to make it clear that the waivers will be exceptional, so that the power does not become a mechanism for avoiding the need to ask for consent.
	The second effect of this group of amendments is to provide that, instead of orders to dispense with the need for consent in the case of "missing persons" and "non-responders" being made by the High Court, directions will be issued instead by the HTA. The intention is that, in due course, the functions of the HTA, including this one, will be taken over by the regulatory authority for fertility and tissue, which will be responsible for both fertility and tissue matters.

Evan Harris: I want to ask the Minister about something in the first part of her remarks. Is she confident that Lords amendment No. 6 is narrow enough in scope to refer only to a person's specific treatment needs? Some people will argue that it is wide enough, especially given its reference to "scientific or medical information", to include purposes that might be considered research. Although that might benefit someone later, there does not have to be a specific individual whose needs must be considered immediately. Is the amendment narrow, or could it be applied more widely?

Rosie Winterton: The aim of the amendments and the clauses that have been referred to is simple. We want to be able to determine whether something is likely to affect the person involved directly—whether, as I said, a person might be liable to contract a disease. The provision may therefore be called a mixture of research and treatment: research in the sense that it is about what might happen in the future, and treatment in the sense that it deals with what a person might receive in the meantime to prevent a possible illness in the future.
	Asking whether the provision covers research or something that would lead to treatment is therefore rather like asking how many angels can dance on the head of a pin, but I shall be happy to help further if the hon. Gentleman wants to pursue the matter.

Evan Harris: I will have another stab at this, and I may try and raise it later if I catch your eye, Mr. Deputy Speaker. Lords amendment No.6 talks about
	"another person (including a future person)",
	but says nothing about the need to identify that person at the time. As a result, some people may try to use the provision to get the HTA, as opposed to the High Court, to waive the requirement for consent in the case of a non-responder. I make no judgment about that one way or the other, but the requirement would not be waived when there was a person—or a future embryo, or a family— in a clinic who needed the treatment. The Government have rejected previous amendments that would have given the HTA power to use the information for research purposes.

Rosie Winterton: That is dealt with separately. This amendment concerns a specific individual making an application because it would directly benefit him or her. If a person is worried that a particular condition may develop, that person must be able to get information about a relative. That is different from a researcher trying to do research, which is dealt with elsewhere.
	The Government recognise that extending the "missing persons" order under clause 7(1) and schedule 5(9) to "non-responders" may result in an increase in the number of applications to waive consent to use tissue in these situations. It is clear, however, that the numbers will still be small. There are 18 genetics centres in England, for example, and we might anticipate that each might have a couple of cases a year. We consider that it should remain an exceptional circumstance, but to save any potential burden on, and cost to, the NHS and to make it easier for both professionals and patients, we consider it appropriate for such applications to be made to the Human Tissue Authority rather than to the High Court.
	The Government consider that, taken together, this group of amendments provides a pragmatic solution to a situation that, while not common, could damage the interests of certain patients. We cannot countenance overriding a clear refusal of consent, but we have now provided for two sets of circumstances in which it may not be possible to get consent to use tissue to benefit another person. That will allow, in particular, genetic information from one person to be used to benefit the health care of a relative.

Andrew Murrison: The amendments relate to clause 7, which was introduced late in our consideration of the Bill and in response to representations made by researchers, principally geneticists. The group is titled,
	"Powers to dispense with the need for consent".
	In a sense, that strikes at the heart of the Bill, because it is all about consent. Therefore, we need to tread a little warily. That said, the Opposition believe that the change is a pragmatic move that will strike the difficult balance between putting consent at the heart of everything we do medically and ensuring that researchers, especially in genetics, are not disadvantaged in the work that they do on behalf of us all.
	I am sure that the Human Tissue Authority will be careful in drawing up codes of practice and guidance on the need to be assiduous in obtaining consent. We agree that the default position introduced by clause 7—that the authority may dispense with the need for consent if no response is received—implies that some effort has been made to ensure that the person concerned does not object to the use of their tissue. I suspect that some cases will emerge every year, given the sensitive nature of the issues surrounding genetics and DNA, in which people do object for a variety of reasons, some that we can imagine but others that we cannot. After all, genetics is a rapidly evolving science and will no doubt in future provide information about people that we are not presently aware of. For example, some religious groups may take exception to the use of tissue for this purpose and wish to object. In the case of objection, it would be inappropriate for the authority to have any powers to override. We must be sure that we give people every opportunity to object to the use of tissue and it is clear that we need, as a matter of some urgency, codes of practice from the authority that will clarify those points.
	I have expressed the only concern that we have about the amendments. Broadly speaking, we welcome them, although it is a shame that they have been introduced at this late stage. We are concerned that some of the wording may be confusing, especially with regard to what is relevant directly to a person's condition and what might be relevant later. However, with that in mind, we will give the amendments a fair wind.

Richard Taylor: I tabled amendment (a) as a probing amendment. Like the hon. Members for Westbury (Dr. Murrison) and for Oxford, West and Abingdon (Dr. Harris), I was concerned particularly about two phrases in Lords amendment No. 6. The first is
	"obtaining scientific or medical information about the person".
	That phrase exactly fits definition of research in the "Oxford English Dictionary" as well as the wider definition of research. The Minister has already clarified that, in this amendment, "research" is meant in the narrow sense of looking specifically at features of the donor that could affect people in the future.
	My other query was about the definition of "another person". Could it mean other persons? Unless that is clarified, the wording could open the door to research on a wider circle of people. I would be grateful for absolute clarification of those two slight ambiguities.
	While I have the chance, may I say how delighted I am that almost all the changes that we struggled to obtain in Committee have now reached the Bill at this stage?

Evan Harris: I wish to raise three points with the Minister on this group of amendments and, in particular, Lords amendment No. 6. I have already made the first point in an intervention on the Minister. I asked whether the amendment might be used to obtain permission for research without consent from the authority and not from the High Court, as provided for in clause 7(3). As the hon. Member for Wyre Forest (Dr. Taylor) said, it might be argued that to obtain scientific or medical information to help another person or future person is, by definition, a particular type of research project. The Minister kindly confirmed that we should be reassured—or, in the case of those who might have wished to use the provision to make such applications for permission, disappointed—because it is necessary for a person who would benefit from the information to make the application for permission to obtain it. Where in the amendments is the requirement for an application, or does some other provision in the Bill make it impossible for the application to be initiated unless by a person with specific diagnostic or treatment needs?
	Will the authority have to decide applications for the purpose of research? Does the Minister think that it is appropriate that applications for research purposes should be decided by the High Court, as provided for in clause 7(3), rather than the authority? Will that make it difficult for any applications to be made, whatever their merits, because of the cost? If the Minister believes—as indicated by the amendments accepted in the other place—that the authority is expert enough to make decisions about dispensing with consent in some cases, why should it be the High Court that makes the decision about dispensing with explicit consent for other applications, such as those for research? I hope that I have made my concerns on that point clear. If not, I would be happy to accept an intervention to clarify them further.
	Secondly, I would be grateful if the Minister would clarify the steps she expects will be taken to ensure that the donor from whom the authority is being asked to gain consent for the use of their tissue or genes has not died. The amendment refers to there being "no reason to believe" that the donor has died, which mirrors an amendment we discussed on Report—I think that that is worth returning to—but it talks elsewhere about "reasonable efforts" having been made to get the donor to decide whether to consent. If the donor had died, my understanding is that it would not be possible for that to be done, so one might argue that reasonable efforts ought to be made to establish whether a non-responding donor has died.
	I presume that the clause is constructed around the knowledge that the person is not dead, but if it is the case that they are alive and not responding, it is curious that one would even need to mention the condition that there be no reason to believe that the donor had died. I am a little unsure of the circumstances in which that provision might apply and of the steps the Minister believes should be taken. Clearly, those who have died will not respond. I would be interested to know how she envisages certainty being obtained as to which applies.
	The third issue relates to lack of capacity, and the Minister will be aware that I have raised that before. I understand that both Houses will debate the matter in the context of the Mental Capacity Bill. However, subsection (d) of amendment No. 6 states that
	"there is no reason to believe. . .that the donor lacks capacity to consent to the use of material for that purpose".
	It is thus clearly the Government's understanding that the Mental Capacity Bill will be used in that case to decide whether consent can be obtained. It is important that we debate that now, because this is the best place to get an idea from the Government now that Bill has been published—it was not when we previously debated this matter—on whether the best interests test is the best way forward.
	It is hard to argue on an understanding of best interests that it is ever, narrowly, in someone's best interests to allow their material to be used for someone else's benefit. The Minister can say that best interests include what they would have wanted to do for a member of their family, but it seems to me that it would be better—I make this case again—to avoid the term "best interests" and use the expression "not against the best interests of the person concerned". That is a good example, and shows how using such terminology will not change the actual outcome, but it is a more honest way of saying how we are going to deal with issues of lack of capacity. Otherwise, people might feel that such cases are stretching the term "best interests" further than it need go.
	I would be grateful if the Minister would comment on whether she envisages that it would almost always be the case—even though it is not always the case for a donor with capacity—that the advocate or their substituted decision maker would allow such a decision to be made. I hope that that is clear. Like the hon. Member for Westbury (Dr. Murrison), I welcome the fact that we are debating a series of amendments that have improved the Bill and I am pleased that the Government accepted—albeit in another place—some of the amendments that were pressed, which had their echo during debates that took place in this House.

Patsy Calton: I want to bring to the attention of the House a number of points that have surfaced recently from the cancer research world, on which I seek clarification from the Minister. The concerns relate to material that has been stored previously, such as material stored several years ago. As someone whose material was stored several years ago, I can speak with some authority on the matter. I understand that ethics committees are already refusing permission because of the lack of consent in cases such as that of my own stored material. A number of people in my position would be horrified to think that material that had been lying in a tissue bank for some years could not be used now because of misunderstandings about the intentions of the Bill.
	I understand that Herceptin was discovered because of work that was done with material that had been stored—exactly like my own material—during the last few years. First, I would like the Minister to clarify whether material such as that stored six to eight years ago requires additional consent. Secondly, if consent is required, what form will it take? Will it require more than simply a letter to the last known address? Thirdly, are repeated consents necessary for new research as it arises? I apologise if that does not fit completely with Lords amendment No. 6, but like my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris), I was not clear whether "another person" referred to a specific person. I thought that the point was broader and would thus be acceptable.
	I would be grateful if the Minister would clarify the three points I made about stored material from persons such as myself, who would be horrified to think that such material could not be used because ethics committees were erroneously of the opinion that fresh, modern, up-to-date consents of the type required by the Bill had to be obtained for every item stored in the past.

Rosie Winterton: First, I shall deal with the amendment tabled by the hon. Member for Wyre Forest (Dr. Taylor). I hope that during the course of my opening remarks, I can clarify some points for him. I am sure that he is aware that the effect of his amendment would be to extend the waiving of consent applications for research purposes, which is why we could not accept it. We have said quite clearly that it is not about getting consent for research purposes, but about a link with an individual. To clarify his point, we have used the term "person" because it refers to an individual who wishes to find out information about the effect on themselves, or possibly their children. If someone was making a decision about whether to have a baby, for example, and felt that they might pass on a condition that a relative suffered from, it would be possible for consent to be waived in those circumstances. For those reasons, we cannot accept the amendment, but I hope that what I have said clarifies the points raised by his probing amendment.
	I shall move on to points made by the hon. Members for Westbury (Dr. Murrison) and for Oxford, West and Abingdon (Dr. Harris). It is absolutely vital that proper efforts are made to locate a person and ensure that although they have received information, they have not in fact responded to it. The question of ascertaining whether someone had died would be covered by the attempt to find out whether they would respond to the information. The provision obviously concerns tissue from the living. If we were talking about someone who had died, the process would revert to getting consent from a relative.
	Under the clause, the applicant should show that there is no reason to believe that the person has died. If it was necessary to prove that there was reason to believe that the person had died, those involved would have to revert to obtaining permission from a relative to use the stored material, so reasonable efforts would have to be made. The clause is nothing to do with trying to carry out research without gaining consent, as was suggested by the hon. Member for Oxford, West and Abingdon.
	The reason why those issues can be dealt with by the Human Tissue Authority, rather than by the High Court, is that it will be possible to show that efforts have been made to contact the person or there will be clear evidence that the person is missing, so taking such cases to the High Court would be excessive.

Evan Harris: The Minister may have missed this, but my specific question was how she could be certain in her view, which she gave in answer to my earlier intervention, that an application under Lords amendment No. 6 must come from a person in a clinic who seeks a diagnostic or therapeutic intervention and could not be initiated by a clinician who seeks to use the tissue of someone who cannot be traced or who does not respond for the generic purpose of helping people in the future, even in circumstances that can be defined but are not specified. The Minister said that the application must originate from a person in the clinic. I should be grateful to her if she would say where that is made clear in the Bill.

Rosie Winterton: Such things must relate to the interests of another person—an individual—and the application to the Human Tissue Authority must state that that person has asked that an attempt be made to obtain the material from their relative because they believe that they may have a certain condition. It must state that the proof that they have that condition is X and the reason why they want to find that out is Y, because the person may need treatment in between, perhaps to stop the condition developing.
	The hon. Member for Cheadle (Mrs. Calton) asked about existing holdings. Existing holdings are exempt from consent provisions, but we will say in the code of practice—we expect research ethics committees to consider this at the moment, as we have said previously—that those involved should try to obtain consent from an individual if it is clear from using existing material that they were likely to identify, because they knew from whom the material had come, something that might affect the individual in the future or that might link to another condition.
	If research ethics committees anonymise the material, it can be used anyway. Anonymising the material does not necessarily mean that they would not have access to a person's medical records, so they could look at the treatment that the person had received, but they would not know who the person was. However, it is for individual research ethics committees to consider the proposed research and decide whether it would be necessary, if at all possible, to get the person's consent because the research may have a direct effect on them. I hope that that answers the hon. Lady's questions.
	Finally, the most appropriate method of getting permission from people who lack capacity is to obtain a relative's consent. The Mental Capacity Bill makes clear the steps that must be undertaken to obtain consent where, for example, research is to be carried out. However, if research is not involved, those involved must ensure that the necessary consultation takes place, while also considering the person's best interests. It could be in a person's best interest to have their tissue used to benefit a relative. As hon. Members may know, there have been some recent examples where a person who is looking after someone without mental capacity has wished to obtain treatment because they can then find out what is affecting them. So there may be a wider best interests test.
	With those reassurances, I hope that the House will accept these Lords amendments.
	Lords amendment agreed to.
	Lords amendments Nos. 5 to 17 agreed to.

Clause 33
	 — 
	Restriction on transplants involving a live donor

Lords amendment: No. 18

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this we may discuss Lords amendments Nos. 40, 43 and 47.

Rosie Winterton: Lords amendments Nos. 18, 40, 43 and 47, which were moved by the Government, implement a recommendation made by the Delegated Powers and Regulatory Reform Committee in its 25th report, published on 16 July. The Government are grateful, as always, to the Committee for its detailed consideration of the Bill. These Lords amendments put right an anomaly in the Bill that was noted by the Committee.
	Clause 33 deals with transplants from living patients. It is brought forward from, and updates, the Human Organ Transplants Act 1989. In effect, it states that live transplants carried out using transplantable material are unlawful unless carried out in circumstances, and in accordance with procedures, set out in regulations. Through that approach, we can specify the type of material to which the offence applies, as well as the circumstances in which live transplants may be allowed—for example, where no coercion or payment is involved—and specify how case-by-case approval must be sought from the Human Tissue Authority.
	We use the term "transplantable material" because transplants no longer only involve organs—the term can relate to part-organs or different tissue samples—and because it can be updated by regulation, as new procedures are developed.
	Under the Bill, the Human Tissue Authority must make the regulations that define the term "transplantable material", while the Secretary of State has the power to make regulations setting out how and when cases would be subject to an approval procedure. The Secretary of State's power is subject to affirmative resolution in both Houses and the HTA's power is subject to no parliamentary scrutiny at all. The Committee pointed out that inconsistency, and the Government have accepted its recommendation.
	We accept that both regulation-making powers should be subject to the same level of scrutiny, and the amendments will thus make the definition of transplantable material a matter for regulations subject to the affirmative procedure made by the Secretary of State. As with the other affirmative powers in the Bill, the Secretary of State will have to consult the National Assembly for Wales and the relevant Northern Ireland Department before acting under the powers.

Andrew Murrison: Although we can agree that the Lords amendments appear to increase the transparency of the way in which transplantable material will be defined, will the Minister confirm that that is the purpose of Lords amendment No. 18? Lords amendments Nos. 40, 43 and 47 appear to say that the Secretary of State may define transplantable material, but that that could not be annulled by a resolution of the House. I am somewhat confused about that, so I would be grateful for her clarification.

Evan Harris: I welcome the amendments because it is always important to ensure that the House has the opportunity to comment on such regulations.
	Does the Minister think that altruistic donation will fall within the procedures on which she expects the Secretary of State to make regulations? In Committee in the House of Lords, there was a debate on altruistic donation and on whether current arrangements allow for stranger donation or indeed domino donation. I have tabled parliamentary questions about the matter because it is unclear whether regulations that the Secretary of State has already promulgated under equivalent provisions in existing Acts allow such donations to take place. If the Minister does not think that that is the case, will she give me an undertaking that under the power that the amendments will rightly give the Secretary of State through clause 33(7), rapid progress will be made to provide a structure under which the relevant authority may determine whether such donations may go ahead? I have received many representations from people who believe that it should be possible to make such donations.
	If the Secretary of State is to make regulations instead of the authority—it will have rather less on its plate than him, albeit still a lot—it would be helpful if the Minister could assure me that she and her colleagues are considering the issue urgently. People have been telling me for several years that the existing regulations do not allow the relevant authority to permit such donations. The Minister might think that this is a small point, but people's lives depend on ensuring that the pool of donors is as wide as possible, so I hope that she will be able to address my point.

Rosie Winterton: The hon. Member for Westbury (Dr. Murrison) is right that the purpose of Lords amendment No. 18 is to give the power to the Secretary of State. The other amendments are consequential and relate to the procedure for making regulations.
	To respond to the point made by the hon. Member for Oxford, West and Abingdon (Dr. Harris), altruistic donations are not prohibited at present, but the Unrelated Live Transplant Regulatory Authority does not currently allow them. The Human Tissue Authority will be in a position to consider altruistic donation further, and I know from our debates on Report and in Committee that the hon. Gentleman is concerned about the supply of transplantable material. However, although such donation is not prevented at the moment, ULTRA has the power to decide whether a procedure can go ahead. The matter is being considered, but as I am sure that he knows, many issues must be resolved before we can proceed. The HTA will be able to consider altruistic donation and will do so.

Evan Harris: Is the Minister saying that if such donations are to be considered and carried out, new regulations under clause 33(7) need not be promulgated and the Secretary of State need not give approval?

Rosie Winterton: Nothing prevents the donations at the moment except for the fact that ULTRA makes decisions about which donations can happen. If ULTRA said that altruistic donations could go ahead, I am not sure whether the Secretary of State would have to approve that. I suspect that ULTRA currently has the power to make the decision without referring back to the Secretary of State, but if that is not the case, I shall certainly write to the hon. Gentleman.
	Lords amendment agreed to.

Clause 35
	 — 
	Inspectorate of anatomy and pathology

Lords amendment: No. 19

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Mr. Deputy Speaker: With this is it will be convenient to consider Lords amendments Nos. 20 to 28, 31 to 33, 41, 42, 45, 46, 48, 58, 59, 70 and 71.

Rosie Winterton: The structure of the Human Tissue Authority originally envisaged under the Bill was a single authority incorporating two inspectorates that would license and inspect regulated activities. The inspectorate for anatomy and pathology would have dealt principally with consent and ethical issues in relation to such matters as teaching anatomy and tissue banking for research. The inspectorate of organs and tissue for human use would have regulated banks holding tissue for transplantation and implemented the safety and quality protocols of the EU directive on tissues and cells.
	As a result of the review of the arm's-length body, the Government announced in July that the Human Tissue Authority will merge its activities with those of the Human Fertilisation and Embryology Authority when the current review of the Human Fertilisation and Embryology Act 1990 is complete, which is likely to be in about 2008. At that time, both the HTA and the HFEA will be subsumed into a new organisation called the regulatory authority for fertility and tissue, or RAFT.
	The Government listened to the debate on the structure of the inspectorates of the Human Tissue Authority in the other place and reconsidered their position. We believe that it will be helpful for the HTA to have maximum flexibility as it organises its activities alongside those of the HFEA and prepares for the eventual merger. We thus tabled the large group of amendments to remove the inspectorates of anatomy and pathology and of organs and tissue for human use from the structure of the HTA. The amendments will also allow the HTA to delegate its inspection and licensing functions to any members and staff of the HTA, or a committee composed of members and staff, or both.
	The amendments will not in practice affect the way in which the authority will inspect and regulate licensed activities. It will still be able to call on the advice of experts in the various fields that it regulates, but it will operate in as streamlined a way as possible. It will still be possible for the HTA to hear appeals against decisions taken by those to whom it delegates certain functions, for example committees that deal with licensing decisions.
	Opposition Members asked us in Committee to ensure that the system was not overly bureaucratic. I hope that the amendments address some of the points raised.

Andrew Lansley: Clauses come and clauses go, and quite a number are going in this respect.
	The amendments address some of the questions raised about excessive bureaucracy, but we need further assurances. It was generally understood that one of the originating reasons for the design of the legislation, with the two parallel inspectorates under the authority, was not least because of the existing body of expertise and the confidence that was placed in the inspectorate of anatomy in particular. We were only too aware that the tragic events that gave rise to the mischief that the Bill is intended to remedy did not arise in respect of functions inspected by the inspectorate of anatomy. The measures partly originated to assure people that things done well, not least by the inspectorate of anatomy, would not be messed about. So the first assurance that we need is that the existing body of relevant expertise built up in the inspectorate of anatomy will be properly protected in the HTA.
	That said, we are happy that what might have become a bureaucratic structure of parallel boards all within one authority is being dispensed with and that the HTA is being given the flexibility to structure its functions. Although the Minister did not refer to this, I am sure that she would recognise that clause 40 extends to the authority the ability to manage itself by giving agency functions to other public bodies and authorities. Given the intention to combine the HTA and HFEA into the regulatory authority for fertility and tissues from 2008, there are immediate questions for the HTA to consider about the extent to which it establishes parallel functions or agrees with the HFEA that they carry out functions on a jointly administered basis from the outset. I hope that the Minister can confirm that clause 40 does not bar any of that happening.
	The amendments would probably have been desirable regardless of the arrangements proposed between the HFEA and HTA. They are not contingent on those two bodies being pushed together. However, the Minister has put them in that context, which raises one or two important issues.
	The Minister will not be surprised if I remind her that on Third Reading on 28 June at column 118, I asked whether it was the intention of the Government, who had initiated the review of arm's-length bodies at that stage, to combine the work of the HFEA and HTA. Those of us who served on the Standing Committee were only too well aware that the two authorities were designed to function in a similar manner, and we raised that issue in February. Happily, our advice was that if that was the Government's intention, they should at least tell the other place before the Bill completed its passage. That was overtaken in September by further announcements on the review.
	It does, however, mean that we are proposing to introduce the HTA for it to disappear at a future point into a new and different authority. That will only reinforce the public's occasional cynicism about the nature of the legislative process and how we conduct things. I say "we" advisedly. Governments of perhaps all descriptions tend to set things up with greater frequency than they get rid of them. At least on this occasion two turn into one rather than the other way around.
	Many people who were surprised at the Retained Organs Commission disappearing before the HTA arrived will also be surprised to find that the HTA will be around for just three years. That raises a serious question, which the Minister should answer. The Government are looking for members of the HTA, comprising a chair and up to 14 members, with the understanding that they will be in office for three years. That is a normal term, but there is also the expectation that the authority will disappear after three years because it will be wrapped up in early 2008 and replaced by the new authority. There will be competing interests from members of the HFEA and HTA. Does that make sense? Is there a case for joint appointments to the two authorities and for anticipating some of the changes?
	It is not for any of us to anticipate what Parliament may dispose of in relation to statutory bodies in future legislation, but we made it clear in Committee and on Third Reading that the two authorities could be run together and operate as one. There are compelling reasons to look critically at the range of inspectorates, going beyond the two authorities. I talked to hospitals about the number of inspectorates to which they were subjected in the course of their daily business. One drew up a list with 42 inspectorates.
	I raised the problem at a meeting and discussed it with the chief executive of the Healthcare Commission. She did not think that 42 was correct. I thought that she would say that there are far fewer, but on the contrary I was astonished to find that she reckons there are 102 inspectorates. I have not seen that list, but these two inspectorates are part of the burgeoning inspection process overall.
	It is essential to find ways to rationalise inspection. The Healthcare Commission wants to do that, and I hope that the Government support it to the utmost extent. Although authorities have responsibilities, which clearly have to be discharged, those institutions that are inspected find that if inspectors talk to one another, the duplication is removed and the processes of providing data and information are rationalised, including the processes of providing access and giving people the opportunity to visit premises and to put specific activities in context. The role of inspectors could be rationalised in a way that minimises the burden of inspection. Happily, clause 43, which requires the authority to
	"carry out its functions effectively, efficiently and economically"
	and to have regard to best regulatory practice, should help us to ensure that it has no choice but to participate. However, it depends on the Healthcare Commission exercising its function, and doing so aggressively.
	My next point relates to the authority's membership. Before these clauses were removed, there were different mechanisms by which different areas of expertise would be included in the authority's decision-making processes, either through membership of the HTA itself or through the two boards or the two inspectorates. In the absence of those boards, it is even more important that the authority and its members can bring the relevant expertise and perspectives—I am distinguishing between the two—to their work.
	The advertisement for the authority's chair and membership posts—which I note, for anybody listening to our debate, requires completed applications by tomorrow—gives examples of the areas of knowledge and experience from which people may be drawn, dividing them between lay and professional members. Examples of those who may want to apply to be professional members include pathologists, coroners, anatomists, surgeons, researchers and pharmacologists, which seems to imply that professional and academic expertise is being sought.
	A range of examples are given for lay members, including the areas of media and finance, but no specific reference is made to industrial experience. I am thinking of the pharmaceutical industry, biotech industry or bio-industry experience. I do not understand how we are to try to ensure that some of the issues concerned, such as tissue banking and the conduct of research in a commercial context, which we have discussed in our proceedings on the Bill, will be covered by the relevant expertise.
	Dividing the advertisement into lay and professional members and not including any reference to private sector and industrial expertise begs the question whether such expertise is likely to be included. It may depend on whether biochemists and pharmacologists who have worked in pharmaceutical or bio-industries are appointed. Let us face it: 13 categories of members are instanced in the advertisement, and only 12 appointments—up to 12—other than the chairman, will be made through the NHS Appointments Commission. It may therefore be difficult to ensure that members have the relevant expertise.
	In Committee, my hon. Friend the Member for Westbury (Dr. Murrison) referred to the experience of pathologists. Although we know that there is no place for a representative, as it were, of the Royal College of Pathologists, it is difficult to see how the authority could conduct its business without being sure that it could draw on the expertise of a pathologist and, perhaps, an anatomist and someone with not only a pharmacological background but an understanding of the use of tissues in research. There are specific areas of expertise that clearly have to be represented.
	I hope that we can have some assurance from the Minister that although the appointments are being conducted on Nolan principles, excluding conflicts of interest and ensuring that any appointment is entirely on merit, the NHS Appointments Commission will make it absolutely clear that specific areas of expertise and knowledge need to be represented on the authority if it is to be able to perform its functions effectively.
	Subject to all those points, we, like the Government, are happy to remove the clauses from the Bill by way of these amendments.

Evan Harris: I certainly agree with the hon. Member for South Cambridgeshire (Mr. Lansley) that neither the review of arm's-length bodies nor the particular conclusion of he review was required to argue that there should be flexibility for a new authority to maximise its efficiency by not simply seeking to transplant into it inspectorates from existing provision. That, arguably, seemed an easier thing to do at the outset than implementing what is now the very short provision in Lords amendment No. 58, which enables the authority to organise these matters as it wants.
	I have a further point to make about the implications of the review of arm's-length bodies. To ensure that I remain in order, I do so only in the same terms as the debate in the Grand Committee in the House of Lords. These amendments presume that the merger of the HTA with the HFEA is sensible and rational. We have not had an opportunity for parliamentary debate on that, and that will not happen until Parliament, through primary legislation, approves that measure. That is not intended to happen for several years, and anything may happen in that time, including a general election.
	Both bodies have inspectorates and an inspection function. Nevertheless, it has been argued, not least by Lord Jenkin of Roding, for whom I have a great deal of respect on these matters, that the merger is not rational policy making. I would argue that the HFEA and the Human Genetics Commission might have more in common. I hope that the Government still have an open mind on the matter and that it is still open for debate, particularly given the fact that the Science and Technology Committee is due to report on the HFEA and its future, which will hopefully inform the Department of Health's review. I understand the Government's wish to reduce the burden of regulation and the number of bodies, but that has to be done in a rational way. The fact that both the bodies that the Minister has indicated should be merged have inspectorates is not sufficient argument for the measure.
	Further to the points that have just been made about the advertisement for jobs that has just gone out, I say to the House that part of the problem with the way in which policies and decisions are made is that the Government are advertising for people to apply for jobs in an organisation that will effectively be abolished, or at least merged, a few years down the line. The timing is unfortunate, to say the least; we are setting up new authorities only to have advertised in advance the fact that people will need to reapply for the jobs within a short time.
	We accept the amendments on the understanding that while the Select Committee is looking at the issue and her Department is looking at the HFEA's future, the Minister realises that acceptance does not commit us to the view that the merger between the HTA and the HFEA is right. Although a merger may be a good thing in and of itself, we hope that there is room to explore whether the precise mergers proposed by the Minister are appropriate, given that there are issues other than inspection that various arm's-length bodies need to deal with.

Rosie Winterton: I shall tackle one of the last points first. The people who apply for a job with the HTA will be aware of the position. It would have been more difficult for them if they had been appointed and then told, perhaps a year later, that the body was to be merged. When we talk about merging the two bodies to become the regulatory authority for fertility and tissue, it will be clear in which direction the body to which people are being appointed is going.
	The hon. Member for Oxford, West and Abingdon asked whether the merger was appropriate. The HFEA currently licenses in vitro fertilisation, fertility clinics and the storage of sperm, eggs and embryos. We believe that its approach and structure and those of the HTA are similar and that merging will not significantly disrupt their activities.
	I want to reassure the hon. Member for South Cambridgeshire (Mr. Lansley) that we do not want to lose any expertise that has been built up. Anatomy organisations will provide input through membership of the HTA. We will look to Her Majesty's inspector of anatomy for advice in drawing up codes. Various clauses set out the authority's remit and inspections will continue to be carried out. However, we have made it clear that we want the authority to have maximum flexibility in undertaking its duties.
	Let us consider the current relationship between the HFEA and the HTA. Clause 40 assists by providing for a close working relationship between the two bodies. We are already considering ways in which the HFEA can work with us, for example, in providing back-office facilities and so on. That process can start almost immediately.
	The hon. Member for South Cambridgeshire also mentioned the advert that has been distributed. It has been brought to the attention of the BioIndustry Association and the Association of the British Pharmaceutical Industry. We are open to applications from all sectors. Nothing is ruled out. The advert gave examples but others can apply. Furthermore, the HTA will regularly consult some of the experts that the hon. Gentleman mentioned. The NHS Appointments Commission must make decisions about the best candidates and consider, for example, his point about possible conflict of interest. It must take such matters into account.
	We will ensure that we keep and build on the expertise that has accumulated over the years. We believe that our approach will ensure that no unnecessary duplication takes place and that we can move quickly to build in the sort of stability to which I referred so that people who come into post are well aware of the organisation's future direction and can participate in it.

Andrew Lansley: I assume that the Bill does not exclude the possibility of appointment to both the HFEA and the HTA.

Rosie Winterton: That possibility is not excluded. Indeed, in some cases, it might be helpful in emphasising joint working. Again, it is for the NHS Appointments Commission to consider all the applications on their merits.
	I hope that, with those assurances, hon. Members will accept the amendments.
	Lords amendment agreed to.
	Lords amendments Nos. 20 to 28 agreed to.
	Lords amendment: No. 29

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Madam Deputy Speaker: With this we may discuss Lords amendment No. 30.

Rosie Winterton: Clause 44 ensures that activities that are carried out for criminal justice purposes are excluded from regulation by the HTA. By criminal justice purposes, we mean the prevention, detection, investigation and prosecution of crimes, including appeals. However, the exclusion does not extend to coroners' post mortems.
	One aspect deals with what happens when a body, or part of a body, is found at what is clearly a crime scene. We want to ensure that the police and investigating authorities are not hindered in carrying out their responsibilities. Although mortuaries that carry out post-mortems will have to have an HTA licence and be subject to periodic inspection, we would not require licensing of a crime scene, which might, for example, be in a forest, simply because a forensic pathologist needed to remove tissue samples at the scene.
	Removing tissue from the deceased for a post-mortem examination is licensable, even when it is done for criminal justice purposes. Although in most cases the removal of samples could wait and be carried out in the licensed mortuary, there will be cases in which, as part of the criminal investigation, it is necessary to leave the body where it lies and take samples away for analysis.
	Clause 44 therefore has two effects. Subsections (1) and (2) exclude from the regulatory regime of part 2 anything done for criminal justice purposes, other than the coroner's post-mortem examination. Subsection (3) excludes from the licensing requirement the removal of tissue for the purpose of investigating a suspicious death from a body at the scene where it is found. For example, when a person dies of a heart attack, the coroner might ask for a post mortem. That examination would be conducted in a place licensed and inspected by the HTA.
	However, when a body has been found and it seems that a crime was involved, it might be important for the criminal investigation for samples, for example of blood, to be taken before the body is moved. As that would be part of the coroner's post-mortem, clause 44(2) provides that the location where the body was found must be licensed before the sample can be taken. That is clearly not sensible. We have, therefore, through clause 44(3), provided for the removal of tissue in those circumstances, once the police have attended, to be outside the regulatory scheme.
	None of this has been contentious, but the difficulty that emerged during consideration in another place was the lack of clarity in the meaning of subsection (3), which is designed to ensure that coroners' post-mortem activities that take place "at the scene" do not require a licence from the HTA. The mention of the constable was possibly ambiguous as it could have referred to the police first removing tissue from the body, or to bodies being found only by the police, as opposed to passers-by. We recognised the possible ambiguity, so we tabled amendments Nos. 29 and 30 to clarify the purpose of subsection (3).
	The usual expression "at the scene" was previously expressed as
	"at the place where the body or part is first found by a constable."
	Clearly, people other than the police will often find bodies, which may also be moved after having been found but before the police are involved. To avoid ambiguity, the amendments change the description of these "at the scene" post-mortem activities from
	"at the place where the body or part is first found by a constable"
	to
	"at the first place, where the body or part is situated, to be attended by a constable."
	I hope that that is clear. I recognise that these formulations are not elegant or easy, but I assure the House that the revised wording at least removes any possibility of ambiguity. Put simply, the exemption from licensing should apply only to the place where the police first arrive on the scene. I urge the House to accept the amendments.

Andrew Murrison: I congratulate the Minister on dealing with an extremely clumsy amendment in her usual elegant fashion.
	I shall describe to the hon. Lady one eventuality, which fortunately happens rarely—the situation that faces advanced trauma life support personnel. I should be grateful if she would say how the clause would classify and deal with the situation that I am about to describe. It concerns the scene of an accident or a crime at which, in order to get to a survivor to uncover them or to treat them, it is necessary to deal with someone who is deceased. That might mean moving the person or, in rare cases, removing parts of that person. How would such an eventuality be dealt with under the clause?

Rosie Winterton: The clause deals with a coroner's post-mortem. What the hon. Gentleman described is the moving of a body from one place to another to try and reach another person to give them treatment. That is not necessarily relevant to the clause, which states that a coroner's post mortem must be licensed, but there will be circumstances where it may be necessary to take tissue from a body in order to assist the coroner's post mortem. That is where the clause applies. I hope I have correctly understood the situation that the hon. Gentleman describes.

Andrew Murrison: Perhaps I can expand a little further. If a doctor was required, for example, to remove a part of a body—disarticulate a part of it—in order to get to or to treat someone who was living, how would he or she stand in relation to the clause?

Rosie Winterton: The doctor would not be affected by the provision because, as I said, it applies to the situation where a coroner's post mortem was being carried out. One would look elsewhere for the actions that would be taken in respect of the situation that the hon. Gentleman describes. I do not know the relevant legislation that would cover it, but it sounds as though someone was taking action to help someone else. I do not believe the clause would apply.
	Lords amendment agreed to.
	Lords amendments Nos. 30 to 35 agreed to.
	Lords amendment: No. 36

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.
	Clause 52 enables the de-accessioning—that is, moving out of their collection—of human remains by specified museums that are currently prevented from doing so by their governing statutes. The clause fulfils the terms of the July 2000 joint declaration between the UK and Australian Prime Ministers, in which the UK Government undertook to increase efforts to repatriate human remains to Australian indigenous communities.
	Lords amendment No. 36 is a response to representations made to the Government on behalf of the museum sector, which, while recognising the need to provide for de-accessioning of the remains of indigenous peoples, was nevertheless concerned to ensure that the power did not make the collections held by the museums listed in clause 52 vulnerable to gratuitous or vexatious claims for de-accessioning. There was particular concern about the ancient collections of human remains in the British Museum, such as mummies. The amendment that we tabled responds to this concern by ensuring that the remains of people believed to have died more than 1,000 years before the clause comes into force are outside the scope of this power. The amendment was prepared following discussion between the Department for Culture, Media and Sport and the relevant museums, particularly the British Museum, the museum of London, and the natural history museum.
	There are a number of reasons why the Government adopted the present formulation. First, specifying a cut-off point of 1,000 years will allow the museum of London to make use of this power in de-accessioning the substantial number of mediaeval remains in its collection, such as remains that originate from mediaeval burial grounds. The original proposal by peers on behalf of the museums had suggested a 500-year cut-off, but that would have prevented the use of the power for the de-accessioning of this category of material.
	Secondly, I am told that dating such ancient remains can be rather difficult. There are a number of ways in which human remains can be dated. These include radiocarbon dating, and the examination of the circumstances in which the remains were found and of the artefacts with which they may have been buried. However, none of those methods will necessarily pinpoint the date of death to a precise year. We have therefore formulated this amendment so that it will be sufficient that the remains are "reasonably believed" to be those of people who died less than 1,000 years before the clause comes into force, in order for them to fall within the scope of the de-accessioning power. The Government's formulation therefore allows for professional judgment to be exercised on the part of museum curators, archaeologists and other experts regarding the dating of the human remains. I therefore hope that hon. Members will agree to accept the amendment.

Andrew Murrison: I welcome the amendment. Like many others, my family and I enjoyed the mummy exhibition at the British Museum during the summer, and it would be a tragedy if those exhibits were to be dispersed. My understanding is that that would be prevented by the amendment and, to that extent, we welcome it. I am fascinated by the repatriation of indigenous remains, and the Minister clarified that that had taken place chiefly in response to requests by the Australian Government for the return of Aboriginal remains. I am not an expert in this field—the Minister is indicating that she is not an expert either, although I am sure that she is—but I suspect that there are other indigenous communities who would also be interested in this legislation, and I am concerned that there might be some remains that they would like to be repatriated.
	As I understand it, this provision has to do with important artefacts. Clearly, mummies are important and the collection at the British Museum is of international importance. I suspect, however, that there are remains lurking in the depths of some museums that are of less significance historically and archaeologically, and it would be nice to think that, if they were significant to the communities from which they originally derived, they might be repatriated, even if they were more than 1,000 years old. I would be grateful to hear whether the Minister knows of any requests regarding such remains that might be made in the future and, if so, whether it might be appropriate to amend the proposal in some way so as to allow the professional judgment, as she put it, of the curators of the remains to prevail.
	I am concerned about the term "reasonably believe", because the dating of these artefacts can, as the Minister hinted, be rather an inexact science. Carbon dating is probably the most exact, but other means, such as examining the artefacts buried with the person, might be slightly less specific. My concern is that curators could be tempted to cherry-pick the method by which they determine the age of an artefact if there were any doubt about whether the remains fell within the strictures of the Bill. What safeguards does the Minister envisage in that regard? Does she envisage any guidance being issued to museums on best practice in determining the age of artefacts?

Robert Key: Just as my predecessors at Old Sarum—all two of them—represented five electors, I have the privilege of representing no electors at Stonehenge. However, I do represent a large archaeological community in south Wiltshire, which contains many hundreds of scheduled ancient monuments. I am also a member of the all-party group on archaeology.
	I warmly welcome the amendment. It was first proposed in the other place by Lord Redesdale and Baroness Kennedy that there should be an amendment to do what has now been achieved in finding the right balance between real and effective claims, particularly from first nation communities—all of which now fall within this time bracket—and the need properly to preserve archaeological collections for future research. There is, however, a little matter on which I would be very grateful to receive some advice.
	The Trust for Wessex Archaeology, which is based in my constituency, is now the second biggest contract archaeologist. It moves in whenever excavations for road building, housing or industrial development have to be undertaken to satisfy the grant of planning permission for such developments, and it regularly comes across bodies. They might or might not be 1,000 years old. There is already, therefore, a Home Office licensing regime for excavating in certain circumstances, and there is no problem with that. However, I have been asked to seek clarification on one aspect of licensing.
	I have read the Bill, obviously, and I have read clause 52. I have also read clause 16, in particular, which deals with licence requirements, but I cannot find anything to satisfy my query. An archaeologist excavating a site might comes across a body—probably only a skeleton—that will eventually end up in a museum somewhere. One hopes that it would be the Salisbury and South Wiltshire museum, which is by far the finest museum in the south of England. When the body is betwixt and between the original site from which it was excavated and its final resting place in a museum, is a licence required under the Bill? That is not quite clear. How would the interface work between the Home Office licensing regime and a licence required under the Bill? That is a practical consideration. I would frankly be amazed if even this excellent Minister could answer that question off the top of her head, or even with a little inspiration from on high. Therefore, if she cannot produce an answer this afternoon, I would be grateful if she could drop me a line on the matter, and put a copy in the Library of the House, so that we can clear up this practical point for the many hundreds of archaeologists who find bodies in these circumstances every day.

Rosie Winterton: With regard to the issue raised by the hon. Member for Salisbury (Mr. Key), I hope that I will be able to give him some reassurance. If he is not fully reassured by my sudden attempt to become an expert in this area, I can assure him that, if he wished to write to Ministers at the Department for Culture, Media and Sport, they would be more than happy to go into detail on this matter. However, clause 16(4) provides that no licence is necessary in relation to the bodies of people who died more than 100 years before the Bill comes into force. Licences are necessary only in relation to certain activities, all of which are limited to scheduled purposes. Archaeologists may remove material from bodies for the purpose of determining the cause of death, in which case a licence would be required, but only if the body were less than 100 years old. Clause 16(4) was introduced precisely to meet the concerns of archaeologists in this regard. I hope that that is helpful, and I would like to thank the hon. Gentleman for giving my officials notice that he would raise this matter.
	The hon. Member for Westbury (Dr. Murrison) sought clarification of whether we know of any further applications that have been made with regard to ancestral remains. The answer is no. I do not know of any other applications. I am sure that he will appreciate that the idea behind de-accessioning and the request for return of remains is that an ancestral link should be established, hence the Aboriginal connection and the attempt to meet the request from the Australian Government.
	With regard to the issue of reasonably believing, and how that would be interpreted, the Department for Culture, Media and Sport will issue guidance following its current consultation on human remains in museums. With those clarifications, I hope that the House will accept the amendments.
	Lords amendment agreed to.
	Lords amendments Nos. 37 to 48 agreed to.

Clause 57
	 — 
	Orders and regulations

Lords amendment: No. 49

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.
	This one should be easy—[Laughter.] The amendment requires that the Secretary of State should exercise his powers to make orders and regulations on a number of issues under the Bill only after having consulted
	"such other persons as he considers appropriate".
	That is in addition to the existing requirement to consult the devolved bodies, where appropriate. The amendment responds to requests made by various people wanting to be reassured that consultation with relevant stakeholders would take place. While we had indicated that such consultation would invariably take place in any event, but we nevertheless agreed to set that down in the Bill.
	The provision applies to the more important secondary powers in the Bill—the orders and regulations listed at clause 57(4), which will be subject to the affirmative resolution procedure. The amendment makes it a statutory requirement that, in each of those cases, the Secretary of State should consult. I urge the House to agree to the amendment.

Andrew Murrison: The—[Interruption.] The Minister invites me to say yes. She suggested that the amendment might be straightforward, but nothing is ever straightforward.
	Of course, we welcome the amendment. It was a long time coming, however, because one thing that has not characterised the Bill, and its passage through both Houses, is consultation. We might have to return to the subject of pre-legislative scrutiny, but I thought that I would take this opportunity to moan about the lack of it and the fact that the Bill might have been improved earlier had we consulted more widely.
	Clearly, the amendment, as far as it goes, is welcome. My noble Friend Earl Howe was instrumental in including this measure in the Bill, and he is to be congratulated on that, as on much of the Bill to which he has contributed. The amendment, however, is a little thin, as all it does is put a duty on the Secretary of State to consult those whom he feels it appropriate to consult. It would be helpful if the Minister, without committing herself too much, could give us an indication of who those consultees might be.

Evan Harris: I had not realised that this amendment would be an issue, and perhaps I have overlooked something, but I would be grateful if the Minister would provide clarification.
	Although the Minister's briefing refers to a list of provisions under clause 57(7)—to which we added section 33(7) in an earlier group of amendments—that list does not correspond entirely with the list given in the amendment, even though her briefing note implies that it should. Obviously, some clauses have been removed, so I do not expect her to defend consulting on clauses that do not exist. For example, section 4(10)(b), section 8(4)(d), section 16(3) and a couple of others are listed as provisions under which the Secretary of State
	"shall consult the National Assembly for Wales and the relevant Northern Ireland department"
	before acting, but some in that list are not included in the list in Lords amendment No. 49. If that is the case, can she clarify the reason why?

Rosie Winterton: Those who would be consulted would include professional bodies, family-patient organisations, religious groups and individuals who had been involved in our consultation on the Bill, and in the earlier review and consultation exercises. Anyone else who expressed a view or an interest in issues covered by the consultation could also be included. I do not want to prescribe an exclusive list, and I assure the hon. Member for Westbury (Dr. Murrison) that we want consultation to be as open as possible.
	The hon. Member for Oxford, West and Abingdon (Dr. Harris) said that the list did not correspond with that in clause 57(7). The orders or regulations to which we refer are subject to affirmative resolution under clause 57(4).
	Lords amendment agreed to.
	Lords amendments Nos. 50 to 54 agreed to.

Clause 65
	 — 
	Commencement

Lords amendment: No. 55

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.
	The amendment would allow a three-month gap between publication of the codes of practice relating to consent and implementation of the penalties relating to consent in clauses 5 and 8. That would enable practitioners to prepare to meet the necessary standards in order to eliminate any risk—which would in any event be very small in the case of anyone already working to proper standards—that they might inadvertently commit offences during the transition period.
	An amendment of this sort was proposed in the other place, reflecting a certain anxiety about the possibility that some practitioners might need to adapt to some aspects of the new legislative framework, especially as they will look to guidance to help them to understand their specific responsibilities. Having agreed to examine the issue further, my noble Friend Lord Warner returned with this amendment.
	We recognise the importance of allowing people an opportunity to become familiar with the implications of the legislation, including the codes of practice that will help to support the required standards. That is particularly so when criminal sanctions may be at issue.
	Consultation during the drafting of codes of practice will keep stakeholders in the picture, and it seems most unlikely that the codes will diverge significantly from what is currently considered to be good practice. For example, the taking and recording of consent for use in research of tissue following a post-mortem examination is already the norm, and health professionals have no reason to be nervous of a legislative framework that will support that approach.
	Nevertheless, we recognise that there are anxieties. The three-month delay introduced by the amendment will allow everyone to be confident that they are complying with any new standards before the penalties take effect.

Andrew Murrison: We heard on Second Reading and in Committee of the anxieties of many who work in the research community about their liabilities and potential penalties under the Bill. In particular, I recall corresponding with Cancer Research UK, which was of the opinion that such measures might put off people who wanted to enter research. I hope that they will not be put off—I am sure that they will not be, particularly as the Bill has been revised as it has passed through both Houses and now appears to be sensible. However, we must be mindful of the fact that many of those who have been observing what has been going on have been filled with a certain amount of trepidation, are a little uncertain and are concerned about how they stand personally in terms of their legal liabilities.
	I welcome the measure, which will mean that people will be able to get to grips with the codes of practice well in advance of them beginning to bite, which is right and proper. However, the measure should not be used to delay the rolling-out of the codes of practice. It is important that we crack on with that.
	Lords amendment agreed to.

Schedule 1
	 — 
	Scheduled purposes

Lords amendment: No. 56

Rosie Winterton: I beg to move, That this House agrees with the Lords in the said amendment.

Madam Deputy Speaker: With this we may discuss Lords amendments Nos. 57, 60 and 61.

Rosie Winterton: On several occasions, arguments have been advanced to the Government, from both within and outside the House, suggesting that the Bill as drafted would have an adverse impact on the training of doctors and researchers. The difficulty related to the question of whether consent should be needed for the storage and use in training related to research of residual tissue samples following diagnostic or clinical procedures. We have listened long and hard to all the points that were made and recognised that there is some force behind the arguments.
	Following debate in the other place, several Opposition amendments were passed to clause 1, schedule 1 and schedule 5. Those all had the intention of allowing use of residual tissue for research education and training without any consent, or with certain safeguards. Taken together, however, those amendments would have been unworkable. Therefore, we tabled Lords amendments Nos. 57, 60 and 61, which, when taken with Lords amendment No. 56, achieve a similar but more consistent and clear effect.
	The amendments remove education and training in research techniques from part 1 of schedule 1, allowing that purpose to be subsumed within education and training in human health, so that it will be lawful to store and to use tissue from the living for both those purposes without consent under part 2 of schedule 1. Amendments to schedule 5 will similarly allow DNA analysis for education and training in research techniques without consent.
	We chose that route to allow education and training in research techniques without consent, rather than the alternative option proposed in Opposition amendments of tissue anonymisation, for reasons of simplicity and clarity. We initially took the view that the use of residual samples for that purpose was too far removed from the original reason for taking the sample—for diagnosis or treatment—for the material to be used without consent. Unlike training in clinical and diagnostic procedures, training in research techniques is not part of what patients would ordinarily regard as part of the package of receiving treatment. That is why we felt that consent would be needed or, as a minimum, some other protection, such as anonymisation.
	We heard many arguments relating to the potential difficulty of distinguishing between education and training in research and that required for clinical practice, because the processes themselves are often the same. Moreover, we recognise that the training of doctors must include research training, and training activities will often include both clinical and research trainees. We therefore considered it best to save further confusion by aligning the two—clinical and research training—under the general heading of "Education or training relating to human health" in paragraph 9 of schedule 1.

Evan Harris: Can the Minister confirm that even though the Bill no longer specifies that education or training relating to research should be considered as education or training relating to human health, rather than research, it is her expectation that it should be understood to be so considered by those operating within the Act, and indeed by the courts in the event of any challenge?

Rosie Winterton: Yes, I can certainly confirm that.
	I must emphasise one point: this will not provide a back door to the use in research of tissue without consent. For example, this will not permit people to undertake such research without consent simply by involving a research trainee. That is not the idea at all.
	Training and education in research techniques are clearly distinct from carrying out research. Research is concerned with creating new knowledge by addressing clearly defined questions with systematic and rigorous methods. Training, on the other hand, is more about showing medical students or technical trainees how to use equipment or about showing them research methods. So research, and training and education in relation to research, are distinct activities.

Andrew Murrison: Can the Minister confirm that a research ethics committee would clearly be bound by the Act, so no confusion is possible between research and treatment activities?

Rosie Winterton: Yes, I can certainly confirm that.
	While storing and using tissue for training purposes will now fall under part 2 of schedule 1, and may be done without consent, storing and using tissue for research itself will remain under part 1 of the schedule, requiring consent or, alternatively, anonymisation and, as the hon. Gentleman said, ethical approval for the project concerned, whether or not a research trainee is taking part. Of course, a trainee will often observe properly approved research, but that does not make it a training activity.
	We can imagine a situation in which a research project is being carried out and a research trainee is also being taught. The researcher is examining tissue for the project and then demonstrating the technique to the trainee. Clearly, both activities—each for a different purpose—are taking place: one is research, the other is training. The training purpose does not require consent, but the research purpose still requires consent or REC approval with anonymisation. Satisfying the requirements for one activity does not obviate the need to satisfy the requirements for the other.
	We have listened very carefully to the debate on this issue and I believe that we have come up with a solution that is pragmatic, in that it enables appropriate training to take place without undue restrictions, while ensuring that the door is not opened to research being conducted without proper approval. I hope that Members will welcome these amendments, which fully meet the concerns expressed in previous debates in this House and in the other place. I urge Members to accept them.

Andrew Murrison: Along with the amendments relating to clause 7, Lords amendment No. 56 is probably the most crucial that we have considered today. It is fairly straightforward, in that it removes from schedule 1 the reference to
	"education or training relating to . . . research".
	In so doing, it addresses many of the concerns expressed to us by the research community. I know that it must have been very difficult for the Minister to allow this amendment. The Bill is about consent, and the amendment rows back slightly from that; however, in our view it is a pragmatic solution that should allow the research community to proceed relatively unhindered with the important work that it does on our behalf, while retaining the Bill's original purpose. So to that extent, we of course welcome the amendment.
	Residual tissue was a hotly contested issue in Committee and the general public have a clear view on the difference between the handling of organs from a corpse for such purposes and residual tissue taken from operations—in other words, tissue taken from somebody who is alive. Emotionally, the two are profoundly different, and we have finally managed to get a Bill that adequately reflects that difference. Of course, several months ago that was not the case. The two were closely allied, even though the popular perception and feeling was that they were quite different. The original Bill was out of line with popular sentiment in that regard, and given that it stemmed from the Kennedy, Redfern and Isaacs inquiry, I found that rather surprising. But we got there eventually, although it has been a hard slog. Given that the Bill is not partisan but very technical, it is a great pity that it was not subjected to pre-legislative scrutiny. The issues that this amendment and others have dealt with could have been sorted out by discussing them with the relevant expert organisations, but we will simply have to live with that in the months and years ahead.
	We can all think of problematic situations—they have been described to us at great length—in which this amendment will help. We can perhaps envisage the law being broken every day in every medical school throughout the country, with one side of a lecture theatre learning how to treat patients and the other learning about research techniques, fundamentally the same instruction being given and the poor lecturer in the middle, trying to wade his way through the legislation to make sure that he is steering a proper course and not transgressing the law in any way. This problem is particularly relevant to cytology. Noble Lords discussed cytology in another place in defence of their amendments, the substance of which was eventually accepted by Ministers. We clearly need to train people in histopathology and cytology, which involve staining. Many stains are used in the course of therapeutics, but many others are research tools. Both can now be dealt with at the same time during the instruction of those who are learning how to treat patients and those who are learning research techniques.
	It would make no sense at all to retain the Bill as originally drafted, as it would cause major disruption to medical schools. I believe that the amendments help to get around most of the problems. To that extent, they are extremely welcome and I am very pleased to see them. I am just sorry that we could not have reached this point sooner.
	The downside, of course, has been an element of confusion in the minds of many who work in this field—pathologists, researchers, people in the NHS and in research generally—and they may be left wondering what is going on. I very much hope that any such confusion will be short-lived and that they will be able to get on with their work in the certain knowledge that they will not be transgressing when they carry out activities that most of us would regard, in a common sense way, as perfectly reasonable.
	I share the Minister's hope that the amendment will not prove to be a back door to research without consent. I come back to the original tenet of the Bill, stemming from the tragedies at Alder Hey and the Bristol royal infirmary, that consent must be at the heart of everything that we do. I hope that neither this amendment nor any others will degrade or detract from that original intention. Indeed, I am sure that they will not.

Evan Harris: I shall comment on the specific amendment and then associate myself with some of the more general remarks made by the hon. Member for Westbury (Dr. Murrison). We are now at the last group of amendments, so it will be our last debate on the Bill.
	The amendment deals with an important issue. Previously, the Government were in a bizarre position, as I pointed out on Report on 28 June this year when I said:
	"If the education and training in research techniques were done on anonymised tissue, subject to the approval of a research ethics committee,"
	it would not
	"be exempt from the requirement for consent, as the research is"
	because the Government had specified that such education and training in research techniques required explicit consent. A weird situation would have arisen, whereby parts of the research materials would have required explicit consent while other parts were anonymised. The Minister said:
	"Yes, that is the case."—[Official Report, 28 June 2004; Vol. 423, c. 98.]
	The Minister understood the problem that there were at least three categories of consent in that regard. There was education and training, which did not need consent; research that did not need consent as long as the samples were anonymised and gained research ethics approval; and training in research techniques that would always require explicit consent.
	It would have been good if the Government had reflected further on the problem and tabled their own amendments, such as we now have, earlier in the other place. That would have shown their recognition, after consultation, of the problem. However, I understand that on Report in the other place, the Government resisted the proposals and pressed for a Division. Only following the Government's defeat at that stage did they table the necessary correcting amendments to ensure consistency. As the hon. Member for Westbury said, those amendments were important and the Minister has accepted that. We have to say that, on this occasion, unlike the others where the Government clearly listened and volunteered the amendments themselves, we had to wait for the Government to fail to secure a majority in the House of Lords. Thank goodness for the fact that it is a more proportional Chamber, if I may put it that way—[Interruption.] I will put it that way, at least once on every Bill.
	Having said that, I wholly concur with what the Minister said about it being necessary to ensure that this is not seen as providing a back-door way to avoid the need for consent in research. The temptations may well be there, because much of the actual stuff of research is done by people who are being trained in some way or another. Indeed, researchers are always in training, up to the highest level. The Minister was right to put the point on the record and I am delighted that the hon. Member for Westbury agreed. We need to be clear and the research community needs to be very clear.
	It will reassure the research community and health professionals working in this field that a sensible option has prevailed in the final stages of the Bill's consideration. I shall not repeat the general points made by the hon. Member for Westbury, although I associate myself with them. With amendments such as this and the others in the group, we can ensure that the Bill is satisfactory for patients and the public, but we must also make sure that people still want to practise pathology and pursue clinical research in this country. They should not have to fight against the interests of the public, as their work is valuable and benefits the public.
	It is true that we need regulation, but we must ensure that we do not have too much bureaucracy. We need a climate that welcomes people into this area of research. We must make sure that they do not feel that they have to disguise the fact of what they do. There is a crisis in recruitment in some of these disciplines and I hope that the Bill will go some way towards dealing with that problem rather than making it worse.

Richard Taylor: I also welcome the amendment and I associate myself with the remarks made by other hon. Members. In its final form, the Bill will be acceptable to the professions, but I have one final question for the Minister. Will she repeat what I think she said earlier about the anonymisation of material collected for research without consent but with the agreement of the ethical committee? Will she confirm that the linkage of material to a patient's disease and the treatment that has been received will remain, despite that anonymisation, as it will be essential?

Rosie Winterton: I can certainly give the hon. Gentleman that assurance.
	As the hon. Member for Westbury (Dr. Murrison) said, this amendment is very important. I am pleased that it enjoys his support and that of the hon. Member for Oxford, West and Abingdon (Dr. Harris). It epitomises the principles on which the Bill is based.
	We wanted the Bill to be based on consent, not least because of the very tragic events at the Alder Hey and Bristol hospitals. At the same time, we wanted to ensure that the regulation that all society wanted us to introduce was accompanied by reassurance that the Bill would be based on the principles of consent. We also wanted to convince the research and medical community that we were not trying to stifle some of the excellent work being done.
	I believe that the Bill achieves all that now, and that, as a result, people will be very willing to give tissue or organs for research and other purposes. At the same time, it will give the medical and research community confidence that it is operating in an environment that they understand, and one that they know that others understand as well.
	Our task has been to get the balance right between those two very important principles. I think that the Bill achieves that and I want to take this opportunity to thank everyone who has made possible amendments such as the one that we are discussing. In that respect, I want to make particular mention of my officials, but hon. Members of all parties in this House, and in the other place, have all contributed to making this a very good Bill. I am sure that it will satisfy some deeply held principles and the requirement that we provide the right atmosphere for the medical and research community to carry out its work. At the same time, it will provide some important safeguards for families, as desired by those who suffered from earlier events. The Bill will also encourage people to engage in the sort of activities that we have talked about. I am grateful to all involved and I urge the House to agree to the remaining amendments.
	Lords amendment agreed to.
	Lords amendments Nos. 57 to 71 agreed to.

EMERGENCY OBSTETRICS (NORTHERN IRELAND)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Ainger.]

Martin Smyth: I am glad to have the attention of the House for this Adjournment debate. Despite its long title, I shall not address the issue of people from overseas who are working in Northern Ireland or in Great Britain. Nor shall I address the issue of those who have arranged beforehand to be in the United Kingdom and are paying for obstetric care. Instead, I shall address a particular problem that has been drawn to my attention.
	The problem came to my attention as the result of an outbreak of racist attacks in a part of my constituency. I investigated the cause of the attacks, because I could not understand why they were happening. In that part of the constituency, people from Africa had lived for years in harmony with their fellow citizens and were involved in various community activities. Then I discovered that a particular house in the area had a regular turnover of women from Africa, who arrived, had their babies, returned to the house and then moved on. They did not help in keeping the place clean and tidy. As a result, others in the community—I do not support them in any way—who had tried to obtain housing themselves, felt that this was a misuse of the property and of the system. The attacks started, and innocent people were affected.
	I subsequently discovered that the activity has moved from that area, but I have been made aware of at least three other houses in the constituency that are bases for similar activity. I have concluded that an active gang or gangs is using the system and milking money from people who have an ulterior aim.
	One of the reasons behind the activity is that under the constitution of the Republic of Ireland, every person born in the island of Ireland, its islands and its seas has an entitlement to be part of the Irish nation. Since then, of course, we have had the Anglo-Irish agreement, which changed everything—or so we were told—and there was no longer a territorial claim to Northern Ireland. However, under the agreement, any person born in Northern Ireland can identify themselves as Irish or British or both. It is against that background that people are trying to circumvent UK legislation. They have organised trips for people to get a foothold in Europe, above all. Having been involved in health care for many years, I am aware that one should not travel by air during the last few weeks of a confinement, so people must be finding another way into the country.
	The most recent case I came across was of someone from Sierra Leone, who came into Northern Ireland from Dublin. In my research into the situation, I sought some guidance and information. I wrote to the Minister on 1 October and received a reply on 15 October informing me that I would shortly receive a reply. I tabled a question and was told something that I have heard regularly from the Department of Health, Social Services and Public Safety in Northern Ireland: as it deals with about 1,690,000 people, it does not keep that many central records, even though we can receive answers to questions about similar things in England. I was told:
	"This information is not collected centrally."—[Official Report, 19 October 2004; Vol. 425, c. 678W.]
	It appears that some sort of scam is going on, someone is making money out of it and our health service is paying the price. As I understand the situation, the women in question have husbands who are well off financially and are in professional positions. I can understand the desire to get a foothold in Europe, but I wonder what impact it is having on our community in Northern Ireland and especially on our health service.
	I am aware, as I am sure others are, that there is currently a case in Great Britain where a person from China is seeking the right of habitation and citizenship on the ground that their child was born in Northern Ireland.

David Burnside: I was not aware of the problem until my hon. Friend raised it during today's debate. Does he agree that our ministerial representatives should raise the issue with their counterparts in the Irish Republic? It is disgraceful that those seeking Irish citizenship should be using the British health service and its facilities in Northern Ireland, rather than using the health service available in the territory of the Irish Republic, which by my definition, constitutionally, is the 26 counties.

Martin Smyth: I thank my hon. Friend for his question. I am sure that our representatives will be asking the question, but they get no answer other than, "We have that problem in the Republic at the moment, too." There was a referendum recently to try to change the constitution of the Republic of Ireland to debar such things, but that will not come into effect until at least the beginning of 2005, and even then I would not hold my breath. I know that people in the Irish Republic are fighting against that legislation, and with elections coming sooner or later, there may be political issues involved in trying to gather votes one way or the other.
	According to the law, emergency obstetric care must be provided free of charge to anyone, and it would appear that our health budget is carrying that burden. I phoned the chief executive of the Royal Jubilee hospital group who, interestingly, acknowledged that there were such cases, but said that there were not very many. I asked my personal assistant to do some checking on the hospitals where I understood such children would be born, and the results are rather interesting. I am not thinking of emergency obstetric care for people who reside in the area—that can happen at any hospital. We specifically asked about those from overseas who have no background of living in the area.
	Daisy Hill hospital tells us that there was a nil return, fascinatingly enough, on the last survey for the Irish referendum, but we do not know whether such cases have happened before or since then, because that is a localised issue. The Erne hospital says that very few people are taken into maternity without prior knowledge, but that leaves the question of whether any are taken in. Lagan Valley hospital tells us that it has no evidence of foreign nationals. I am prepared to accept that, but I cannot understand, as I know a little about north Belfast, why the Mater hospital said that there is no evidence of foreign nationals—whether in general or in particular, I do not know.
	Significantly, Craigavon hospital said that it has several foreign nationals a week. Two women recently presented for delivery who did not know each other, but they gave the same address. That confirms the pattern that I have traced. Altnagelvin hospital in Londonderry says that there is little evidence of such cases, but that they have been known to happen in the past. At the Ulster hospital in Strangford, such cases happen often. Let us remember that the chief executive said that they did not happen too often at the Royal Jubilee hospital group. Of course, he was very compassionate—I understand his compassion; the hospitals have to take anyone who comes—but according to my research, six people are presenting themselves each week.
	About 300 to 400 people have presented between 2002 and the past week or so, and the tragedy is that most of them are presenting off the street. That requires medicals and blood tests because a large number of them come from Africa. With the problems of the AIDS epidemic there, extra medical attention is involved, even though the women may not remain in hospital for very long. However, we are all aware that it is the care and attention at the time of delivery that is most expensive. It is not the nursing attention later or the hospital care—the so-called hotel provision—that adds to the expense, but the procedures involved.
	I wonder whether the Minister can tell us whether any of those hospitals are being given extra funds for such treatment or whether they must take the money from their budgets. She will be aware that most of the hospitals in Northern Ireland are crying out for more—even though it might be a little bit like Oliver when they cry for more because we sometimes wonder what some of them are doing with their money.
	The number of people involved provides us with a challenge. I understand their aspirations; I understand that people want to improve their quality of life. I understand that Irish and British citizenship means much to people throughout the world, but I am not convinced that we should be subsidising people to make a fortune out of the aspirations of some and the miseries of others. We are aware of that when we talk about the trail of asylum seekers who manage to find their way right across the European continent, landing up in different parts our nation when someone else is raking in the money. Those people have gathered what money they have to pay off gangmasters and others. I wonder whether the Minister can tell us whether attempts have been made to investigate the issue. I can help her with one case because I know that the Police Service of Northern Ireland has been out to meet the folk in one home in my constituency—I am waiting to hear what happened.
	Is anything being done beyond Northern Ireland, and in relation to the Irish Republic, to prevent this activity from happening? We must bear it in mind that the problem will multiply because, according to Irish law, people may claim citizenship through three generations. We are not considering only the circumstances tomorrow, but those for the next three decades at least.

Angela Smith: I congratulate the hon. Member for Belfast, South (Rev. Martin Smyth) on securing the debate. He has demonstrated his interest in the matter through his letters to me and his parliamentary questions. The situation regarding emergency obstetric care for patients from overseas worries several hon. Members, so I hope that I can reassure them on questions of care and that problems are being addressed. The hon. Gentleman rightly stated that it is set out in law that emergency obstetric care must be provided free of charge at the point at which it is needed.
	It might be helpful if I give some background to the situation. When the Jubilee maternity hospital was situated at Belfast City hospital, only a small number of women—about four a month—travelled from overseas to give birth there. In the past four years, since the Jubilee joined the Royal maternity hospital to form the Royal Jubilee maternity service, the numbers have steadily increased. As the hon. Gentleman said, the situation affects other maternity units, albeit to a lesser extent. Those units are in the Mater, Ulster, Causeway, Antrim, Craigavon and Erne hospitals.
	Women arriving at hospitals in Northern Ireland are generally at an advanced stage of their pregnancy, and most will present to the hospital at around 38 weeks gestation. As the hon. Gentleman said, they have generally travelled to Northern Ireland via England. In Belfast, the women appear to stay at a small number of addresses in the south and east of the city. The women mainly originate from China, but they are also known to have travelled from Algeria, Nigeria, Syria, Sudan, Uganda and Libya.
	My next point relates to the hon. Gentleman's question about the difficulties with the statistics that we have. The majority of the women who arrive will have visited a general practitioner and will have an address in Northern Ireland, so they will have secured temporary resident status and a health service number. It is then routine for them to be referred to a maternity unit to book a confinement. Others will have no GP, and they will arrive directly at the maternity unit to be booked into what are called emergency booking slots. A very small number of women arrive at the maternity unit already in labour.
	The RJMS, where most women attend, is managing the situation by using an emergency booking clinic, which is led by one of the consultants. Four slots are set aside each week for overseas women, although generally at least another two are also seen. The use of the clinic ensures that proper medical histories can be taken and that clinical tests can be carried out prior to labour. Additionally, a Chinese interpreter is provided as required. The RJMS has stressed that the women receive exactly the same care as local residents.
	Through the establishment of the emergency booking clinic, the RJMS is better able to manage its maternity service and provide the best possible care both to local women who have already booked maternity care and to overseas patients who arrive at a late stage of pregnancy. When there has been a capacity issue at the RJMS, some women from overseas have been transferred to receive maternity care at the nearby Mater hospital.
	As the hon. Gentleman said, figures on the exact number of women who are treated are not collected centrally. There are several reasons why the hospitals have had difficulty collecting data, but the main one is that many women from overseas have a health service number and appear as health and social services board residents. The data available on non-EU residents therefore mask the true picture because those who use Northern Ireland addresses are registered as temporary residents.
	Nevertheless, the trusts have produced some statistical evidence, and I can report that the RJMS, which treats the vast majority of the women, reports that about 24 overseas women a month give birth at the unit. Other units vary from fewer than one a month to about three a month.
	The hon. Gentleman raised a number of issues that I shall try to address in turn. It is estimated that the average cost of a birth at a hospital in Northern Ireland is around £2,000. Health and social services boards fund on the basis of the number of births in their area. The boards provided some £12.5 million to fund maternity care at the Royal Jubilee in 2004–05. The women who stay at Northern Ireland addresses are classed by the health service as temporary residents and are counted in the number of births to residents in a board area, thereby receiving funding. No separate allocation has been made for designated non-EU citizens. That represents a significant spend on services to a client group whose right to be in the UK may be subject to review by other parts of the Government. Nevertheless, under current legislation and guidance to GPs, emergency obstetric care must be administered free of charge.
	The hon. Gentleman also spoke about why the women come to Northern Ireland to give birth. There may be some confusion on that. The primary reason, as he said, appears to be to secure Irish citizenship for the child. As hon. Members are aware, current Irish legislation means that a baby born in Ireland or Northern Ireland—anywhere on the island of Ireland—is entitled to Irish citizenship. Women who travel to Dublin from overseas to give birth have been a major problem and a significant issue in the Republic of Ireland for some time. A referendum was held last year to make residency and nationality changes to the relevant sections of the Irish constitution, thereby stopping wide-scale abuse of the system. In the referendum, 79 per cent. favoured change.
	The Bill has not been passed and is at its first stage. Although it will have an impact, it is difficult to anticipate that the number of women coming to Northern Ireland to give birth for that reason will reduce until it comes into effect. We think that the legislation will be passed by the end of this year or the beginning of next year. From then on, there will be no gain for women giving birth in Northern Ireland to gain Irish citizenship and it is likely that the number of women coming to Northern Ireland for that reason will decline. I take the point that it will not decline immediately because the information has to get through to those women.

Martin Smyth: One of the ideas is that the system is used to get a foothold in Europe. Does the Minister agree that the legislation does not necessarily mean that the children will not get Irish citizenship? Instead, they will have to apply for it when they are 18 or thereabouts. There is no guarantee that they will get it, but it is difficult for us to say that ultimately they will not get it because they will have been born in the land. The change will not necessarily stop them coming.

Angela Smith: The hon. Gentleman perhaps underestimates the complexity of the legislation. It is not simply the case that people can get citizenship. They have to be born, whether in the north or south, to parents, one of whom is an Irish citizen, to be entitled to be an Irish citizen. It is more complex than just the issue of birth. I do not think that there will be the difficulty that he anticipates because of the provisions that are being considered by the Irish Government. I accept that current legislation has led to the increase in the past few years.
	Another group of women who come to Northern Ireland are from Nigeria, but they almost always pay for their treatment before leaving. Since April this year, 42 Nigerian women have paid for treatment at the Royal Jubilee. They are usually booked in in advance and the maternity service has planned for their deliveries.
	I understand the concerns that women arriving from overseas may displace local mothers. I reassure the hon. Gentleman that that is not the case. The trusts have taken steps to address the additional demand, and I mentioned some of those. That demand will be relatively short lived with the arrival of the new legislation.

Nigel Dodds: The Minister said that some non-EU residents have Northern Ireland health numbers, but, for those who do not, what are the costs of providing services to non-EU residents who give birth in Northern Ireland?

Angela Smith: I cannot give the hon. Gentleman an overall figure, but we are talking about a figure of around £2,000 per birth. I will obtain the figures for non-EU citizens and come back to him on that point.
	I acknowledge the professionalism of the staff who deal with these issues in our health service, and particularly acknowledge the pressures on the medical, midwifery, nursing and management staff who deal with these issues in our trusts. They continue to provide a first-class service for local mothers-to-be, while also treating late-booking women from overseas with the same care and respect that they show every mother-to-be. It speaks volumes about their dedication and their concern for their patients. Their hard work, dedication and professionalism should be recognised and thought of as a beacon to us all. I am grateful to them for their efforts.

Martin Smyth: I am grateful to the Minister for giving way again, but we have until half-past 7 anyway, so we are all right.
	I have no problem whatever with joining the Minister in paying tribute to our staff. I would like to put on record the fact that elsewhere in the Palace the radiographer of the year award is being given to one of our citizens, Margaret Grayson, from Northern Ireland.
	Is anybody looking at the routes by which mothers-to-be come to Northern Ireland, so that those who profit from the trafficking of such persons are brought to justice and the burden is not placed on the taxpayer?

Angela Smith: I am grateful to the hon. Gentleman for his intervention not only because it allows me to pay tribute to Margaret Grayson but because it enables me to make a point that I had almost forgotten. I can assure him that we give information fully to the Police Service of Northern Ireland, and the foreign nationals division of the PSNI works closely with the Immigration Advisory Service and there is a free exchange of information. I can give him the utmost assurance that my Department will co-operate fully with the PSNI, the Home Office and the Immigration Advisory Service, which are all investigating the matter. There will be full co-operation, and I hope that that addresses the points that he has raised.
	Question put and agreed to.
	Adjourned accordingly at twenty-eight minutes to Five o'clock.